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Sample records for rectus muscle resection

  1. Rectus abdominis muscle endometriosis

    International Nuclear Information System (INIS)

    Goker, A.

    2014-01-01

    Endometriosis is characterized by an abnormal existence of functional endometrial tissue outside the uterine cavity, typically occuring within the pelvis of women in reproductive age. We report two cases with endometriosis of the abdominal wall; the first one in the rectus abdominis muscle and the second one in the surgical scar of previous caesarean incision along with the rectus abdominis muscle. Pre-operative evaluation included magnetic resonance imaging. The masses were dissected free from the surrounding tissue and excised with clear margins. Diagnosis of the excised lesions were verified by histopathology. (author)

  2. Effects of oblique muscle surgery on the rectus muscle pulley

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    Okanobu, Hirotaka; Kono, Reika; Ohtsuki, Hiroshi

    2011-01-01

    The purpose of this study was to determine the position of rectus muscle pulleys in Japanese eyes and to evaluate the effect of oblique muscle surgery on rectus muscle pulleys. Quasi-coronal plane MRI was used to determine area centroids of the 4 rectus muscles. The area centroids of the rectus muscles were transformed to 2-dimensional coordinates to represent pulley positions. The effects of oblique muscle surgery on the rectus muscle pulley positions in the coronal plane were evaluated in 10 subjects with cyclovertical strabismus and, as a control, pulley locations in 7 normal Japanese subjects were calculated. The mean positions of the rectus muscle pulleys in the coronal plane did not significantly differ from previous reports on normal populations, including Caucasians. There were significant positional shifts of the individual horizontal and vertical rectus muscle pulleys in 3 (100%) patients with inferior oblique advancement, but not in eyes with inferior oblique recession and superior oblique tendon advancement surgery. The surgical cyclorotatory effect was significantly correlated with the change in the angle of inclination formed by the line connecting the vertical rectus muscles (p=0.0234), but weakly correlated with that of the horizontal rectus muscles. The most important factor that affects the pulley position is the amount of ocular torsion, not the difference in surgical procedure induced by oblique muscle surgery. (author)

  3. Waldenstrom macroglobulinemia involving the superior rectus muscle

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    J.B. Hellman

    2018-06-01

    Full Text Available Purpose: We present the first reported case of Waldenstrom macroglobulinemia in the right superior rectus causing diplopia. Observations: A 72-year-old man with a 6-month history of untreated asymptomatic Waldenstrom macroglobulinemia presented with 2 years of diagonal binocular diplopia that was previously thought to be due to ocular myasthenia gravis. Examination showed mild right proptosis and right hypotropia, and MRI revealed a focal lesion of the right superior rectus muscle. Orbital biopsy was performed, and histopathology showed lymphoplasmacytic infiltration among the skeletal muscle fibers of the rectus muscle. Immunostaining confirmed a B-cell preponderance, along with more extensive staining for IgM than IgG, and in situ hybridization confirmed lambda restriction. These findings corresponded with those of his previous bone marrow biopsy, confirming Waldenstrom macroglobulinemia as the etiology for the extraocular muscle mass. Conclusions and Importance: Lymphoma of an extraocular muscle is a rare manifestation of orbital lymphoma, and the tumors are usually mucosa-associated lymphoid tissue (MALT lymphomas (i.e. extranodal marginal zone lymphomas. There are 4 previous reports of lymphoplasmacytic lymphoma of an extraocular muscle; however this is the first reported case of such a lesion in a patient with concurrent Waldenstrom macroglobulinemia at the time of diagnosis. Keywords: Waldenstrom's macroglobulinemia, Lymphoma, Superior rectus, Diplopia

  4. Myositis ossificans in rectus abdominis muscle: case report

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    Ko, Eun Sook; Na, Jae Boem

    2004-01-01

    Myositis ossificans is an ossifying inflammatory lesion occurring within skeletal muscle. Myositis ossificans usually arises in the large muscles of the extremities and this lesion is characterized by progression of mineralization from periphery to center. In the early phase, myositis ossificans simulates malignant soft tissue tumor without dense mineralization. Traumatic myositis ossificans in rectus abdominis muscle has been reported worldwide. The radiologic findings of early active myositis ossificans in rectus abdominis muscle are ill defined heterogenous hypoechoic mass on US, hemorrhage, early strong enhancement and early peripheral mineralization on CT and MR

  5. Myositis ossificans in rectus abdominis muscle: case report

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    Ko, Eun Sook; Na, Jae Boem [Gyeongsang National University College of Medicine, Jinju (Korea, Republic of)

    2004-10-15

    Myositis ossificans is an ossifying inflammatory lesion occurring within skeletal muscle. Myositis ossificans usually arises in the large muscles of the extremities and this lesion is characterized by progression of mineralization from periphery to center. In the early phase, myositis ossificans simulates malignant soft tissue tumor without dense mineralization. Traumatic myositis ossificans in rectus abdominis muscle has been reported worldwide. The radiologic findings of early active myositis ossificans in rectus abdominis muscle are ill defined heterogenous hypoechoic mass on US, hemorrhage, early strong enhancement and early peripheral mineralization on CT and MR.

  6. Isolated abscess in superior rectus muscle in a child

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    Sushank Ashok Bhalerao

    2015-01-01

    Full Text Available Pyomyositis is a primary bacterial infection of striated muscles nearly always caused by Staphylococcus aureus. Development of the intramuscular abscess involving the extra-ocular muscles (EOMs remains an extremely rare process. We herein present a case of isolated EOM pyomyositis involving superior rectus muscle in a 2-year male child who was referred with complaints of swelling in left eye (LE and inability to open LE since last 1-month. Orbital computed tomography (CT scan showed a well-defined, hypo-dense, peripheral rim-enhancing lesion in relation to left superior rectus muscle suggestive of left superior rectus abscess. The abscess was drained through skin approach. We concluded that pyomyositis of EOM should be considered in any patient presenting with acute onset of orbital inflammation and characteristic CT or magnetic resonance imaging features. Management consists of incision and drainage coupled with antibiotic therapy.

  7. Morphological study of the uncommon rectus sterni muscle in ...

    African Journals Online (AJOL)

    Objective: The present investigation has been designed to study the incidence of the rectus stern muscle in German human cadavers dissected in the Kingdom of Saudi Arabia, trying to find a postulation for the development of such muscle when present. Design: Gross dissection of 130 cadavers, of both sexes, was ...

  8. Effects of hyperthyroidism on the rectus muscles in mice

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    Chyong Jy eNien

    2010-11-01

    Full Text Available Background: Structural details of vertebrate extraocular muscles (EOMs have shown an anatomically and functionally distinct laminar organization into an outer orbital (OL and an inner global layer (GL. Since hyperthyroidism alters tissue oxidative metabolism through mitochondrial enzymes, it is expected that structural/mitochondrial changes may be seen in hyperthyroid EOMs. We investigated the alterations in the laminar organization and mitochondrial changes in hyperthyroid mouse EOMs. Methods: Hyperthyroidism was induced in C57BL/6 mice and fresh rectus muscles were obtained to identify functional mitochondria using MitoTracker® Green and confocal microscopy; frozen sections from rectus muscles were stained with anti-rabbit Troponin T (selectively present in the OL to demonstrate changes in the OL and GL of the EOMs. Ultrastructural features of EOMs were studied using transmission electron microscopy (TEM.Results: Of all 4 rectus EOMs studied, the maximum change was seen in the inferior rectus muscle (IR followed by medial rectus (MR. Myofiber cross sectional area measurements and Troponin T staining in the control IR EOMs demonstrated a smaller OL (113.2 ± 3.66 μm2 and higher density staining with Troponin T (90% and a larger GL (411 ± 13.84 μm2 with low intensity staining (10%, while hyperthyroidism resulted in an increased OL (205.9 ± 5.3 μm2 and decreased GL (271.7 ± 7.5 μm2 p=0.001. Confocal microscopy demonstrated an intense staining especially in the outer rims in the hyperthyroid IR which was confirmed by TEM showing structural alterations in the mitochondria and a subsarcolemmal migration. Conclusions: The outer, thinner, orbital layer (OL of the mouse EOM contains smaller diameter myofibers and fewer mitochondria while the inner, larger global layer (GL contains larger diameter myofibers and larger density of mitochondria. Hyperthyroidism results in a significant alteration in the laminar organization and mitochondria of

  9. Abdominal rectus muscle atrophy and midline shift after colostomy creation.

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    Timmermans, Lucas; Deerenberg, Eva B; van Dijk, Sven M; Lamme, Bas; Koning, Anton H; Kleinrensink, Gert-Jan; Jeekel, Johannes; Lange, Johan F

    2014-04-01

    Incisional hernia (IH) can be attributed to multiple factors. The presence of a parastomal hernia has shown to be a risk factor for IH after midline laparotomy. Our hypothesis is that this increased risk of IH may be caused by changes in biomechanical forces, such as midline shift to the contralateral side of the colostomy owing to decreased restraining forces at the site of the colostomy, and left abdominal rectus muscle (ARM) atrophy owing to intercostal nerve damage. Patients were selected if they underwent end-colostomy via open operation between 2004 and 2011. Patients were eligible if computed tomography (CT) had been performed postoperatively. If available, preoperative CTs were collected for case-control analyses. Midline shift was measured using V-scope application in the I-space, a CAVE-like virtual reality system. For the ARM atrophy hypothesis, measurements of ARM were performed at the level of colostomy, and 3 and 8 cm cranial and caudal of the colostomy. Postoperative CT were available for 77 patients; of these patients, 30 also had a preoperative CT. Median follow-up was 19 months. A mean shift to the right side was identified after preoperative and postoperative comparison; from -1.3 ± 4.6 to 2.1 ± 9.3 (P = .043). Furthermore, during rectus muscle measurements, a thinner left ARM was observed below the level of colostomy. Creation of a colostomy alters the abdominal wall. Atrophy of the left ARM was seen caudal to the level of the colostomy, and a midline shift to the right side was evident on CT. These changes may explain the increased rate of IH after colostomy creation. Copyright © 2014 Mosby, Inc. All rights reserved.

  10. Magnetic resonance imaging in dissociated strabismus complex demonstrates generalized hypertrophy of rectus extraocular muscles.

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    Rajab, Ghada Z; Suh, Soh Youn; Demer, Joseph L

    2017-06-01

    Dissociated strabismus complex (DSC) is an enigmatic form of strabismus that includes dissociated vertical deviation (DVD) and dissociated horizontal deviation (DHD). We employed magnetic resonance imaging (MRI) to evaluate the extraocular muscles in DSC. We studied 5 patients with DSC and mean age of 25 years (range, 12-42 years), and 15 age-matched, orthotropic control subjects. All patients had DVD; 4 also had DHD. We employed high-resolution, surface coil MRI with thin, 2 mm slices and central target fixation. Volumes of the rectus and superior oblique muscles in the region 12 mm posterior to 4 mm anterior to the globe-optic nerve junction were measured in quasi-coronal planes in central gaze. Patients with DSC had no structural abnormalities of rectus muscles or rectus pulleys or the superior oblique muscle but exhibited modest, statistically significant increased volume of all rectus muscles ranging from 20% for medial rectus to 9% for lateral rectus (P muscles. DSC is associated with generalized rectus extraocular muscle hypertrophy in the absence of other orbital abnormalities. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  11. Symptomatic endometriosis of rectus abdominis muscle in a patient with uterus didelphys

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    Yavuz Emre Şükür

    2012-03-01

    Full Text Available Background: Endometriosis of the rectus abdominis muscle is a very rare event and it should be kept in mind in the differential diagnosis of women with abdominal wall mass. Case: 42 year-old G2 P2 patient with uterus didelphis was referred with a painful abdominal wall mass of approximately 4x5 cm size. The mass that has contrast matter enhancement on CT was excised with median laparotomy below the umbilicus. The mass which was thought as endometriosis was excised without remaining any pieces to prevent recurrence and primarily repaired. Discussion: Along with the increasing incidence due to increased cessarean rates the endometrial wall endometriosis is an important diagnosis that should not be omitted. The treatment is surgical resection and to we should take care not to leave any pieces to prevent recurrence especially when it is located atypically.

  12. Rectus abdominis muscle flap for repair of prepubic tendon rupture in 8 dogs.

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    Archipow, Wendy; Lanz, Otto I

    2011-11-01

    The clinical use and outcome of the rectus abdominis muscle flap to repair prepubic hernias were evaluated retrospectively. Medical records (2002-2007) of 8 dogs that had a rectus abdominis muscle flap to repair traumatic prepubic tendon rupture were reviewed. Only minor donor site complications were noted, including self-limiting ventral and hind-limb swelling. No long-term complications including recurrence of hernia were noted. The results of this study indicate that the rectus abdominis muscle flap is a clinically useful option for repairing prepubic tendon rupture in dogs.

  13. Two horizontal rectus eye muscle surgery combined with botulinum toxin for the treatment of very large angle esotropia. A pilot study.

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    Khan, Arif O

    2005-01-01

    To evaluate the effectiveness of a proposed new protocol for the primary treatment for very large angle esotropia: two muscle horizontal rectus muscle surgery with simultaneous botulinum toxin A injection in a small pilot study. Eight patients who had esotropia at near (ET') greater than 60 prism diopters (in actuality 70 to 100 prism diopters ET') underwent 2 muscle horizontal rectus surgery with simultaneous botulinum toxin A injection of the medial rectus intraoperatively. This was the only surgical procedure for all patients included in this report. Seven patients underwent bilateral medial rectus recession and bilateral injection, and one patient underwent a unilateral medial rectus recession / lateral rectus resection procedure with unilateral medial rectus injection. Postoperatively, 6 of the 8 patients demonstrated residual esotropia at near of less than 10 prism diopters and were considered "successful" by the conventional criteria of binocular alignment within 8 prism diopters of orthotropia. Two undercorrections occurred in patients with 100 and 85 prism diopters of preop ET' respectively. But 3 other patients with such large deviations had satisfactory results. All patients and families were satisfied with postoperative binocular alignment, so no further surgery was undertaken. The patient who underwent unilateral surgery had the least surgical effect and was the largest undercorrection, probably because only one medial rectus received a Botox injection. Considering only the bilateral cases, results were "successful" in 6 of 7 cases. Most patients suffered an extended period of Botox induced exotropia in the postop' period before recovery from the paresis. One patient had a transient, successfully treated, postoperative strabismic amblyopia while exotropic. Bilateral medial rectus recession with simultaneous botulinum injection is a safe and effective primary surgical procedure for very large angle esotropia. A more extensive study is indicated to

  14. Surgical results of the slipped medial rectus muscle after hang back recession surgery

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    Yasar Duranoglu

    2014-12-01

    Full Text Available AIM:To analyze the surgical results of a slipped medial rectus muscle (MRM after hang back recession surgery for esotropia.METHODS:Twenty-one patients who underwent re-exploration for diagnosed slipped muscle after hang back recession surgery were included in this retrospective study. Dynamic magnetic resonance imaging was performed to identify the location of the slipped muscle. Ocular motility was evaluated with assessment with prism and cover test in gaze at cardinal positions. The operations were performed by the same consultant. Intraoperative forced duction test was performed under general anesthesia. The empty sheath of the slipped MRM was resected and the muscle was advanced to the original insertion site in all patients.RESULTS:The average age of 21 patients who hadconsecutive exotropia with a slipped MRM at the time of presentation was 17.4±5.4y (5-50y. The average duration between the first operation and the diagnosis of the slipped muscle was 25mo (12 to 36mo. The mean follow up after the corrective surgery was 28mo. The mean preoperative adduction limitation in the field of action of the slipped muscle was -2.26 (ranging from -1 to -4. All patients had full adduction postoperatively.CONCLUSION:The diagnosis of the slipped muscle should be confirmed during the strabismus surgery. The slipped muscle may be caused due to insufficient suture and excessive rubbing of the eye. When divergent strabismus is observed after the recession of the MRM, a slipped muscle should be considered in the differential diagnosis.

  15. Diaphragmatic hernia repair using a rectus abdominis muscle pedicle flap in three dogs.

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    Chantawong, P; Komin, K; Banlunara, W; Kalpravidh, M

    2013-01-01

    To report the clinical use of a pedicle flap from the rectus abdominis muscle to repair extensive diaphragmatic tears in dogs with diaphragmatic hernia. Three dogs with a combination of radial and circumferential diaphragmatic tears were studied. The circumferential tear was repaired by suturing the wound edge with the edge at the abdominal wall. A pedicle flap of the rectus abdominis muscle was used for repairing the radial tear. The dogs were examined radiographically for lung and diaphragm appearance and evidence of reherniation at 10 days, and at one, two, and four months after surgery, and fluoroscopically for paradoxical motion of the diaphragm at one and four months. The rectus abdominis muscle pedicle flap was successfully used in all three dogs. The animals recovered uneventfully without evidence of reherniation during the four follow-up months. Fluoroscopic examination revealed no paradoxical motion of the diaphragm. A rectus abdominis muscle pedicle flap can be used for repairing large diaphragmatic defects in dogs.

  16. Frequency of the superior rectus muscle overaction/contracture syndrome in unilateral fourth nerve palsy.

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    Molinari, Andrea; Ugrin, Maria Cristina

    2009-12-01

    Superior oblique palsy is accompanied in most cases by overaction of the muscle's ipsilateral antagonist, the inferior oblique muscle. Overaction and contracture of the ipsilateral superior rectus muscle in patients with unilateral fourth (trochlear) nerve palsy is seldom discussed in the literature. The purpose of this study is to evaluate the frequency of superior rectus muscle overaction/contracture syndrome in patients with unilateral trochlear nerve palsy. The records of 198 patients with unilateral trochlear nerve palsy examined by the authors between July 1987 and July 2008 were reviewed retrospectively. All patients underwent complete eye examination with measurement of the deviation in the 9 positions of gaze and with the head tilted to both sides in all cooperative patients. Selection criteria for superior rectus muscle overaction/contracture syndrome in these patients were as follows: vertical deviation of 15(Delta) or larger in primary position, equal or larger hypertropia with the ipsilateral forced tilt test than with the eyes looking straight ahead, more than 5(Delta) hypertropia of the affected eye in horizontal gaze to the same side, hypertropia in all upgazes, and overaction of the contralateral superior oblique muscle. Of 198 patients, 33 (16.6%) met the selection criteria for superior rectus muscle overaction/contracture syndrome. Superior rectus muscle overaction/contracture syndrome frequently occurs in unilateral superior oblique palsy.

  17. Rectus muscle flap tear as an independent cause of restricted motility.

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    Raab, Edward L; Ackert, Jessica M; Ostrovsky, Ann

    2012-08-01

    Most published cases of rectus muscle flap tear have been associated with orbital trauma of various degrees of severity. When they accompany an orbital fracture, however, it is difficult to determine whether the flap tear is merely an incidental additional finding or a major contributing cause of the resulting restriction. How to treat the flap itself remains an open question. We report a 24-year-old man with an inferior rectus muscle flap tear caused by direct laceration of the muscle. The major finding was a "reverse leash" vertical restriction. Discarding the flap instead of reattaching it did not prevent a successful result. Our case supports the proposition that rectus muscle flap tear can be a restriction-producing entity. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  18. [Foster Modification of Full Tendon Transposition of Vertical Rectus Muscles for Sixth Nerve Palsy].

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    Heede, Santa

    2018-04-11

    Since 1907 a variety of muscle transposition procedures for the treatment of abducens nerve palsy has been established internationally. Full tendon transposition of the vertical rectus muscle was initially described by O'Connor 1935 and then augmented by Foster 1997 with addition of posterior fixation sutures on the vertical rectus muscle. Full tendon transposition augmented by Foster belongs to the group of the most powerful surgical techniques to improve the abduction. Purpose of this study was to evaluate the results of full tendon vertical rectus transposition augmented with lateral fixation suture for patients with abducens nerve palsy. Full tendon transpositions of vertical rectus muscles augmented with posterior fixation suture was performed in 2014 on five patients with abducens nerve palsy. Two of the patients received Botox injections in the medial rectus muscle: one of them three months after the surgery and another during the surgery. One of the patients had a combined surgery of the horizontal muscles one year before. On three of the patients, who received a pure transposition surgery, the preoperative deviation at the distance (mean: + 56.6 pd; range: + 40 to + 80 pd) was reduced by a mean of 39.6 pd (range 34 to 50 pd), the abduction was improved by a mean of 3 mm (range 2 to 4 mm). The other two patients, who received besides the transposition procedure additional surgeries of the horizontal muscles, the preoperative deviation at the distance (+ 25 and + 126 pd respectively) was reduced by 20 and 81 pd respectively. The abduction was improved by 4 and 8 mm respectively. After surgery two patients developed a vertical deviation with a maximum of 4 pd. None of the patients had complications or signs of anterior segment ischemia. The elevation and/or depression was only marginally affected. There was no diplopia in up- or downgaze. Full tendon transposition of vertical rectus muscles, augmented with lateral posterior fixation suture is

  19. SELECTIVE ACTIVATION OF THE RECTUS ABDOMINIS MUSCLE DURING LOW-INTENSITY AND FATIGUING TASKS

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    Paulo H. Marchetti

    2011-06-01

    Full Text Available In order to understand the potential selective activation of the rectus abdominis muscle, we conducted two experiments. In the first, subjects performed two controlled isometric exercises: the curl up (supine trunk raise and the leg raise (supine bent leg raise at low intensity (in which only a few motor units are recruited. In the second experiment, subjects performed the same exercises, but they were required to maintain a certain force level in order to induce fatigue. We recorded the electromyographic (EMG activities of the lower and upper portions of the rectus abdominis muscle during the exercises and used spatial-temporal and frequency analyses to describe muscle activation patterns. At low-intensity contractions, the ratio between the EMG intensities of the upper and lower portions during the curl up exercise was significantly larger than during the leg raise exercise (p = 0.02. A cross-correlation analysis indicated that the signals of the abdominal portions were related to each other and this relation did not differ between the tasks (p = 0.12. In the fatiguing condition, fatigue for the upper portion was higher than for the lower portion during the curl up exercise (p = 0.008. We conclude that different exercises evoked, to a certain degree, individualized activation of each part of the rectus abdominis muscle, but different portions of the rectus abdominis muscle contributed to the same task, acting like a functional unit. These results corroborate the relevance of varying exercise to modify activation patterns of the rectus abdominis muscle

  20. Reply to: Can we avoid rectus abdominis muscle atrophy and midline shift after colostomy creation?

    NARCIS (Netherlands)

    L. Timmermans (Lucas); E.B. Deerenberg (Eva); S.M. van Dijk (Sven); B. Lamme (Bas); A.H.J. Koning (Anton); G.J. Kleinrensink (Gert Jan); J. Jeekel (Johannes); J.F. Lange (Johan)

    2015-01-01

    markdownabstractWe read with interest the letter to the editor by Stephenson et al regarding our article “Abdominal rectus muscle atrophy and midline shift after colostomy creation.” Any attempt to decrease the risk of parastomal herniation should be applauded, because its incidence of greater than

  1. Rectus extraocular muscle paths and decompression surgery for Graves orbitopathy: mechanism of motility disturbances

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    Abràmoff, Michael D.; Kalmann, Rachel; de Graaf, Mieke E. L.; Stilma, Jan S.; Mourits, Maarten P.

    2002-01-01

    PURPOSE: To study possible causes of motility disturbances that may result from orbital decompression surgery in patients with Graves orbitopathy and especially the role of rectus extraocular muscle paths. METHODS: Sixteen patients with Graves orbitopathy were studied before and 3 to 6 months after

  2. Correlation between the Limbus-Insertion Distance of the Lateral Rectus Muscle and Lateral Rectus Recession Surgery in Intermittent Exotropia.

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    Ju-Yeun Lee

    Full Text Available The aim of this study was to investigate whether the limbus-insertion distance (LID of the lateral rectus (LR muscle can be a useful indicator for predicting the surgical effect of recession surgery in intermittent exotropia (IXT. Patients who underwent unilateral or bilateral LR recession for the basic type of IXT were included. The distance between the corneal limbus and the posterior edge of the insertion of LR muscle (limbus-insertion distance was measured intraoperatively using surgical calipers (graded with 0.25 mm precision. We calculated the actual dose-response effect as the difference between the angle of preoperative deviation and the angle of postoperative deviation, and then divided the figure by the total amount of recession at postoperative months 1, 3, and 6. The correlation between the limbus-insertion distance (LID of LR muscle and each dose-response effect was statistically analyzed. A total of 60 subjects were enrolled in this study. The mean LID of LR muscle was 5.8±0.7 mm. The dose-response effect was 3.2±1.0 prism diopters (PD/mm at postoperative month 1, 3.4±1.0 PD/mm at postoperative month 3, and 3.4±1.1 PD/mm at postoperative month 6. The LID of the LR muscle was significantly correlated with dose-response effects in cases of unilateral and bilateral LR recession at postoperative months 3 and 6 (P = 0.01, <0.01, 0.04 and <0.01 respectively. As the LID of the LR muscle increased by 1 mm, the dose-response effect increased by 0.2PD/mm in unilateral LR recession, and by 0.4 PD/mm in bilateral LR recession at postoperative month 6. In conclusion, the LID of the LR muscle can be used as one predictor of the recession effect to assist in surgical planning for IXT. Moreover, undercorrection at the time of LR recession might be considered in patients with long LID of the LR muscle.

  3. A Case of Blunt Trauma of the Eyeball Associated With an Inferior Oblique Muscle and an Inferior Rectus Muscle Rupture.

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    Nitta, Keisuke; Kashima, Tomoyuki; Miura, Fumihide; Hiroe, Takashi; Akiyama, Hideo; Kishi, Shoji

    2016-01-01

    Rupture of the extraocular muscle in the absence of significant injury to the eyeball and adnexa is uncommon. The authors report a case of blunt trauma of the eyeball associated with an inferior oblique muscle and an inferior rectus muscle rupture. A 55-year-old man slipped and fell down hitting his eye on an extended windshield wiper blade. Although he had treatment in the emergency room, he complained of diplopia in the primary position 1 day postoperatively. After noticing ruptures of the inferior oblique muscle and an inferior rectus muscle during exploratory surgery, the authors carefully repaired it. Diplopia in the primary position had disappeared within 1 month after the operation and by 6 months postoperatively. The movement of the eye had almost completely recovered.

  4. Soccer Attenuates the Asymmetry of Rectus Abdominis Muscle Observed in Non-Athletes

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    Idoate, Fernando; Calbet, Jose A. L.; Izquierdo, Mikel; Sanchis-Moysi, Joaquin

    2011-01-01

    Purpose To determine the volume and degree of asymmetry of the rectus abdominis muscle (RA) in professional soccer players. Methods The volume of the RA was determined using magnetic resonance imaging (MRI) in 15 professional male soccer players and 6 non-active male control subjects. Results Soccer players had 26% greater RA volume than controls (Psoccer players (P = 0.42) and in controls (P = 0.75) (Dominant/non-dominant = 0.99, in both groups). Segmental analysis showed a progressive increase in the degree of side-to-side asymmetry from the first lumbar disc to the pubic symphysis in soccer players (r = 0.80, Psoccer players, although this trend was not statistically significant (P = 0.14). Conclusions Professional soccer is associated with marked hypertrophy of the rectus abdominis muscle, which achieves a volume that is 26% greater than in non-active controls. Soccer induces the hypertrophy of the non-dominant side in proximal regions and the dominant side in regions closer to pubic symphysis, which attenuates the pattern of asymmetry of rectus abdominis observed in non-active population. It remains to be determined whether the hypertrophy of rectus abdominis in soccer players modifies the risk of injury. PMID:21541351

  5. Flap tear of rectus muscles: an underlying cause of strabismus after orbital trauma.

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    Ludwig, Irene H; Brown, Mark S

    2002-11-01

    To present an avulsion injury of the rectus muscle after orbital trauma, usually the inferior rectus, and detail its diagnosis and operative repair. Forty-three patients underwent repair of flap tears of 62 rectus muscles. During surgery, we found the muscle abnormality was often subtle, with narrowing or thinning of the remaining attached global layer of muscle. The detached flap of external (orbital) muscle was found embedded in surrounding orbital fat and connective tissue. Retrieval and repair were performed in each case. The causes of orbital trauma were as follows: orbital fractures (15 patients), blunt trauma with no fracture (11 patients), suspected trauma but did not undergo computerized tomographic scan (12 patients), and status after retinal detachment repair (5 patients). Of note, 15 of the 43 patients (35%) underwent repair of the flap tear alone, without any additional orbital or strabismus surgery. Diagnostically, the predominant motility defect in 45 muscles was limitation toward the field of action of the muscle, presumably as a result of a tether created by the torn flap; these tethers simulated muscle palsy. Seventeen muscles were restricted away from their field of action, simulating entrapment. The direction taken by the flap during healing determined the resultant strabismus pattern. All patients with gaze limitation toward an orbital fracture had flap tears. The worst results after flap tear repair were seen in patients (1) who had undergone orbital fracture repair before presentation, (2) who had undergone previous attempts at strabismus repair, and (3) who had the longest intervals between the precipitating event and the repair. The best results were obtained in patients who underwent simultaneous fracture and strabismus repair or early strabismus repair alone. Avulsion-type flap tears of the extraocular muscles are a common cause of posttraumatic strabismus. Early repair produces the best results, but improvement is possible despite long

  6. Ultrastructure of medial rectus muscles in patients with intermittent exotropia.

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    Yao, J; Wang, X; Ren, H; Liu, G; Lu, P

    2016-01-01

    PURPOSE To study the ultrastructure of the medial rectus in patients with intermittent exotropia at different ages.PATIENTS AND METHODS The medial recti were harvested surgically from 20 patients with intermittent exotropia. Patients were divided into adolescent (age18 years, n=10). The normal control group included five patients without strabismus and undergoing eye enucleation. Hematoxylin and eosin staining and transmission electron microscopy were used to visualize the medial recti. Western blot was used to determine the levels of myosin and actin.RESULTS Varying fiber thickness, atrophy, and misalignment of the medial recti were visualized under optical microscope in patients with exotropia. Electron microscopy revealed sarcomere destruction, myofilament disintegration, unclear dark and light bands, collagen proliferation, and fibrosis. The adolescent group manifested significantly higher levels of myosin and actin than the adult group (Pstronger contraction of the medial recti compared with older patients. Our findings suggest that childhood was the appropriate time for surgery as the benefit of the intervention was better than in adulthood.

  7. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation

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    Balius R

    2011-07-01

    Full Text Available Ramon Balius1, Carles Pedret2, Laura Pacheco1, Josep Antoni Gutierrez3, Joan Vives4, Jaume Escoda11Consell Català de l’Esport, Generalitat de Catalunya, Barcelona; 2Centro Mapfre de Medicina del Tenis, Barcelona; 3Spanish National Handball Team, Spain; 4Granollers Handball Club, Granollers, Barcelona, SpainAbstract: Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball.Keywords: rectus abdominis, muscle injury, sonography, MRI, handball 

  8. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation

    Science.gov (United States)

    Balius, Ramon; Pedret, Carles; Pacheco, Laura; Gutierrez, Josep Antoni; Vives, Joan; Escoda, Jaume

    2011-01-01

    Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball. PMID:24198573

  9. Soccer attenuates the asymmetry of rectus abdominis muscle observed in non-athletes.

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    Fernando Idoate

    Full Text Available PURPOSE: To determine the volume and degree of asymmetry of the rectus abdominis muscle (RA in professional soccer players. METHODS: The volume of the RA was determined using magnetic resonance imaging (MRI in 15 professional male soccer players and 6 non-active male control subjects. RESULTS: Soccer players had 26% greater RA volume than controls (P<0.05, due to hypertrophy of both the dominant (28% greater volume, P<0.05 and non-dominant (25% greater volume, P<0.01 sides, after adjusting for age, length of the RA muscle and body mass index (BMI as covariates. Total volume of the dominant side was similar to the contralateral in soccer players (P = 0.42 and in controls (P = 0.75 (Dominant/non-dominant = 0.99, in both groups. Segmental analysis showed a progressive increase in the degree of side-to-side asymmetry from the first lumbar disc to the pubic symphysis in soccer players (r = 0.80, P<0.05 and in controls (r = 0.75, P<0.05. The slope of the relationship was lower in soccer players, although this trend was not statistically significant (P = 0.14. CONCLUSIONS: Professional soccer is associated with marked hypertrophy of the rectus abdominis muscle, which achieves a volume that is 26% greater than in non-active controls. Soccer induces the hypertrophy of the non-dominant side in proximal regions and the dominant side in regions closer to pubic symphysis, which attenuates the pattern of asymmetry of rectus abdominis observed in non-active population. It remains to be determined whether the hypertrophy of rectus abdominis in soccer players modifies the risk of injury.

  10. Specific fibre composition and metabolism of the rectus abdominis muscle of bovine Charolais cattle

    Science.gov (United States)

    2010-01-01

    Background An important variability of contractile and metabolic properties between muscles has been highlighted. In the literature, the majority of studies on beef sensorial quality concerns M. longissimus thoracis. M. rectus abdominis (RA) is easy to sample without huge carcass depreciation and may appear as an alternative to M. longissimus thoracis for fast and routine physicochemical analysis. It was considered interesting to assess the muscle fibres of M. rectus abdominis in comparison with M. longissimus thoracis (LT) and M. triceps brachii (TB) on the basis of metabolic and contractile properties, area and myosin heavy chain isoforms (MyHC) proportions. Immuno-histochemical, histochemical, histological and enzymological techniques were used. This research concerned two populations of Charolais cattle: RA was compared to TB in a population of 19 steers while RA was compared to LT in a population of 153 heifers. Results RA muscle had higher mean fibre areas (3350 μm2 vs 2142 to 2639 μm2) than the two other muscles. In RA muscle, the slow-oxidative fibres were the largest (3957 μm2) and the fast-glycolytic the smallest (2868 μm2). The reverse was observed in TB muscle (1725 and 2436 μm2 respectively). In RA muscle, the distinction between fast-oxidative-glycolytic and fast-glycolytic fibres appeared difficult or impossible to establish, unlike in the other muscles. Consequently the classification based on ATPase and SDH activities seemed inappropriate, since the FOG fibres presented rather low SDH activity in this muscle in comparison to the other muscles of the carcass. RA muscle had a higher proportion of I fibres than TB and LT muscles, balanced by a lower proportion either of IIX fibres (in comparison to TB muscle) or of IIA fibres (in comparison to LT muscle). However, both oxidative and glycolytic enzyme activities were lower in RA than in TB muscle, although the LDH/ICDH ratio was higher in RA muscle (522 vs 340). Oxidative enzyme activities were

  11. Large asymmetric hypertrophy of rectus abdominis muscle in professional tennis players.

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    Joaquin Sanchis-Moysi

    Full Text Available PURPOSE: To determine the volume and degree of asymmetry of the musculus rectus abdominis (RA in professional tennis players. METHODS: The volume of the RA was determined using magnetic resonance imaging (MRI in 8 professional male tennis players and 6 non-active male control subjects. RESULTS: Tennis players had 58% greater RA volume than controls (P = 0.01, due to hypertrophy of both the dominant (34% greater volume, P = 0.02 and non-dominant (82% greater volume, P = 0.01 sides, after accounting for age, the length of the RA muscle and body mass index (BMI as covariates. In tennis players, there was a marked asymmetry in the development of the RA, which volume was 35% greater in the non-dominant compared to the dominant side (P<0.001. In contrast, no side-to-side difference in RA volume was observed in the controls (P = 0.75. The degree of side-to-side asymmetry increased linearly from the first lumbar disc to the pubic symphysis (r = 0.97, P<0.001. CONCLUSIONS: Professional tennis is associated with marked hypertrophy of the musculus rectus abdominis, which achieves a volume that is 58% greater than in non-active controls. Rectus abdominis hypertrophy is more marked in the non-dominant than in the dominant side, particularly in the more distal regions. Our study supports the concept that humans can differentially recruit both rectus abdominis but also the upper and lower regions of each muscle. It remains to be determined if this disequilibrium raises the risk of injury.

  12. Validating the Use of Rectus Muscle Fragment Welding to Control Presacral Bleeding During Rectal Mobilization

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    Eduardo Ayuste, Jr.

    2004-01-01

    Full Text Available The incidence of presacral bleeding during rectal mobilization is low, but such bleeding may be massive and even fatal. Haemostasis can be difficult to achieve using conventional methods because of the complex interlacing of the venous network at the sacral periosteum. Historically, pelvic packing and metallic thumbtacks have been the more commonly used methods in our institution. However, the need for repeat surgery to remove the packs and the difficulties encountered in tack application have forced us to explore other methods. In 1994, the procedure termed muscle fragment welding, which uses electrocautery through a rectus muscle fragment, was introduced to control presacral bleeding. From January 1999 to February 2002, six of 416 patients undergoing pelvic surgery in our institution developed massive presacral haemorrhage and, therefore, this technique was used. Haemostasis was immediate and permanent. No major untoward postoperative events such as re-bleeding or infection were noted. One case developed a second-degree burn in the right elbow due to a misplaced ground conduction plate. Rectus muscle fragment welding is, in our experience, an effective and practical method of controlling presacral haemorrhage.

  13. Rectus femoris muscle flap based on proximal insertion mobilization to cover a groin infected vascular graft.

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    Silvestre, Luís; Pedro, Luís Mendes; Fernandes e Fernandes, Ruy; Silva, Emanuel; Fernandes e Fernandes, José

    2015-10-01

    The rectus femoris (RF) muscle flap, which is widely used to cover groin infected vascular grafts, is usually harvested through distal tendon division and an extensive muscle elevation and transposition into the groin wound defect. A case of a vascular prosthetic graft infection in the groin was successfully controlled after coverage with an RF flap that was harvested based on proximal portion mobilization instead of the conventional distal one. This case suggests that the RF muscle flap based on proximal insertion mobilization is a feasible, effective, technically simpler, and less invasive alternative to cover infected vascular grafts in the groin. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  14. A Subset of Palisade Endings Only in the Medial and Inferior Rectus Muscle in Monkey Contain Calretinin

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    Lienbacher, Karoline; Ono, Seiji; Fleuriet, Jérome; Mustari, Michael; Horn, Anja K. E.

    2018-01-01

    Purpose To further chemically characterize palisade endings in extraocular muscles in rhesus monkeys. Methods Extraocular muscles of three rhesus monkeys were studied for expression of the calcium-binding protein calretinin (CR) in palisade endings and multiple endings. The complete innervation was visualized with antibodies against the synaptosomal-associated protein of 25 kDa and combined with immunofluorescence for CR. Six rhesus monkeys received tracer injections of choleratoxin subunit B or wheat germ agglutinin into either the belly or distal myotendinous junction of the medial or inferior rectus muscle to allow retrograde tracing in the C-group of the oculomotor nucleus. Double-immunofluorescence methods were used to study the CR content in retrogradely labeled neurons in the C-group. Results A subgroup of palisade and multiple endings was found to express CR, only in the medial and inferior rectus muscle. In contrast, the en plaque endings lacked CR. Accordingly, within the tracer-labeled neurons of the C-group, a subgroup expressed CR. Conclusions The study indicates that two different neuron populations targeting nontwitch muscle fibers are present within the C-group for inferior rectus and medial rectus, respectively, one expressing CR, one lacking CR. It is possible that the CR-negative neurons represent the basic population for all extraocular muscles, whereas the CR-positive neurons giving rise to CR-positive palisade endings represent a specialized, perhaps more excitable type of nerve ending in the medial and inferior rectus muscles, being more active in vergence. The malfunction of this CR-positive population of neurons that target nontwitch muscle fibers could play a significant role in strabismus.

  15. Smooth muscle adaptation after intestinal transection and resection.

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    Thompson, J S; Quigley, E M; Adrian, T E

    1996-09-01

    Changes in motor function occur in the intestinal remnant after intestinal resection. Smooth muscle adaptation also occurs, particularly after extensive resection. The time course of these changes and their interrelationship are unclear. Our aim was to evaluate changes in canine smooth muscle structure and function during intestinal adaptation after transection and resection. Twenty-five dogs underwent either transection (N = 10), 50% distal resection (N = 10), or 50% proximal resection (N = 5). Thickness and length of the circular (CM) and longitudinal (LM) muscle layers were measured four and 12 weeks after resection. In vitro length-tension properties and response to a cholinergic agonist were studied in mid-jejunum and mid-ileum. Transection alone caused increased CM length in the jejunum proximal to the transection but did not affect LM length or muscle thickness. A 50% resection resulted in increased length of CM throughout the intestine and thickening of CM and LM near the anastomosis. Active tension of jejunal CM increased transiently four weeks after resection. Active tension in jejunal LM was decreased 12 weeks after transection and resection. Sensitivity of CM to carbachol was similar after transection and resection. It is concluded that: (1) Structural adaptation of both circular and longitudinal muscle occurs after intestinal resection. (2) This process is influenced by the site of the intestinal remnant. (3) Only minor and transient changes occur in smooth muscle function after resection. (4) Factors other than muscle adaptation are likely involved in the changes in motor function seen following massive bowel resection.

  16. Referred pain elicited by manual exploration of the lateral rectus muscle in chronic tension-type headache.

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    Fernández-de-Las-Peñas, César; Cuadrado, Maria Luz; Gerwin, Robert D; Pareja, Juan A

    2009-01-01

    To analyze the presence of referred pain elicited by manual examination of the lateral rectus muscle in patients with chronic tension-type headache (CTTH). A case-control blinded study. It has been found previously that the manual examination of the superior oblique muscle can elicit referred pain to the head in some patients with migraine or tension-type headache. However, a referred pain from other extraocular muscles has not been investigated. Fifteen patients with CTTH and 15 healthy subjects without headache history were included. A blinded assessor performed a manual examination focused on the search for myofascial trigger points (TrPs) in the right and left lateral rectus muscles. TrP diagnosis was made when there was referred pain evoked by maintained pressure on the lateral corner of the orbit (anatomical projection of the lateral rectus muscle) for 20 seconds, and increased referred pain while the subject maintained a medial gaze on the corresponding side (active stretching of the muscle) for 15 seconds. On each side, a 10-point numerical pain rate scale was used to assess the intensity of referred pain at both stages of the examination. Ten patients with CTTH (66.6%) had referred pain that satisfied TrPs diagnostic criteria, while only one healthy control (0.07%) reported referred pain upon the examination of the lateral rectus muscles (P < 0.001). The elicited referred pain was perceived as a deep ache located at the supraorbital region or the homolateral forehead. Pain was evoked on both sides in all subjects with TrPs, with no difference in pain intensity between the right and the left. The average pain intensity was significantly greater in the patient group (P < 0.001). All CTTH patients with referred pain recognized it as the frontal pain that they usually experienced during their headache attacks, which was consistent with active TrPs. In some patients with CTTH, the manual examination of lateral rectus muscle TrPs elicits a referred pain that

  17. Relationship between rectus abdominis muscle thickness and metabolic syndrome in middle-aged men.

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    Eun Sil Choi

    Full Text Available Skeletal muscle has been suggested as an important factor in the pathophysiology of metabolic syndrome. During the aging process, muscle mass is lost in specific body parts. However, few studies have investigated the relationship between site-specific muscle loss assessed using computed tomography (CT and metabolic syndrome. This study was conducted to investigate the association between metabolic syndrome and rectus abdominis muscle thickness at the umbilicus level (RAM, which reflects site-specific muscle loss of the abdomen using CT image.This cross-sectional study was conducted on 725 middle-aged Korean men. Anthropometric evaluation and biochemical tests were performed. The RAMs of the subjects were measured from CT images taken at the umbilicus level.The mean RAM (mean ±SD of subjects with metabolic syndrome was 2.46 ±0.01, which was thinner than that of subjects without metabolic syndrome (2.52 ±0.01, p<0.01. Moreover, RAM decreased as the number of metabolic syndrome components increased (p-value for trend<0.01. RAM was positively correlated with body mass index (r = 0.21, p<0.01, skeletal muscle index (r = 0.26, p<0.01, and creatinine (r = 0.12, p<0.01, while RAM was negatively correlated with age(r = -0.11, p<0.01, abdominal circumference(r = -0.22, p<0.01, fasting glucose (r = -0.10, p<0.01, and triglycerides(r = -0.15, p<0.01. Using a stepwise multiple logistic regression analysis, we found that RAM was an independent factor associated with metabolic syndrome (OR: 0.861, 95%CI, 0.779-0.951, p<0.01. The result was not different in the statistical analysis including the components of MS (OR: 0.860, 95% CI, 0.767-0.965, p = 0.01.RAM was associated with metabolic syndrome in middle-aged men. Moreover, site-specific muscle loss at the abdomen, as evaluated by RAM, also may be a predictor of metabolic syndrome like SMI.

  18. Intramuscular Distribution of the Abducens Nerve in the Lateral Rectus Muscle for the Management of Strabismus.

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    Shin, Hyun Jin; Lee, Shin-Hyo; Shin, Kang-Jae; Koh, Ki-Seok; Song, Wu-Chul

    2018-06-01

    To elucidate the intramuscular distribution and branching patterns of the abducens nerve in the lateral rectus (LR) muscle so as to provide anatomical confirmation of the presence of compartmentalization, including for use in clinical applications such as botulinum toxin injections. Thirty whole-mount human cadaver specimens were dissected and then Sihler's stain was applied. The basic dimensions of the LR and its intramuscular nerve distribution were investigated. The distances from the muscle insertion to the point at which the abducens nerve enters the LR and to the terminal nerve plexus were also measured. The LR was 46.0 mm long. The abducens nerve enters the muscle on the posterior one-third of the LR and then typically divides into a few branches (average of 1.8). This supports a segregated abducens nerve selectively innervating compartments of the LR. The intramuscular nerve distribution showed a Y-shaped ramification with root-like arborization. The intramuscular nerve course finished around the middle of the LR (24.8 mm posterior to the insertion point) to form the terminal nerve plexus. This region should be considered the optimal target site for botulinum toxin injections. We have also identified the presence of an overlapping zone and communicating nerve branches between the neighboring LR compartments. Sihler's staining is a useful technique for visualizing the entire nerve network of the LR. Improving the knowledge of the nerve distribution patterns is important not only for researchers but also clinicians to understand the functions of the LR and the diverse pathophysiology of strabismus.

  19. Combined resection–recession versus combined recession–retroequatorial myopexy of medial rectus muscles for treatment of near-distance disparity Esotropia

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    Ghali MA

    2017-06-01

    Full Text Available Manar A Ghali Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt Purpose: To compare and evaluate the efficacy of two different surgical techniques for the treatment of near-distance disparity esotropia; combined resection–recession and recession–retroequatorial myopexy of medial rectus muscles. Patients and methods: This prospective study included 28 patients diagnosed with convergence excess esotropia who had worn their full cycloplegic refraction and/or bifocal glasses for at least 6 months and still had near-distance disparity esotropia. The patients were divided into 2 groups; Group I underwent combined bimedial rectus muscles resection 2.5 mm from the insertion end with recession based on near-angle esotropia according to current surgical tables with 1 mm add of recession for each muscle, while Group II underwent bimedial recession based on far angle combined with retroequatorial myopexy at 13–14 mm from insertion. A satisfactory result was defined as orthophoria or esotropia <10 prism diopters (∆ at near and distance with reduction of the near-distance disparity to <10 ∆. The patients were followed up for at least 2 years for stability of correction and late onset consecutive exotropia. Results: In Group I, all the patients had satisfactory alignments at near and far with residual near–far disparity ≤10 ∆, no cases of overcorrection at far was reported; while in Group II, all cases had orthophoria at far, but 4 cases (28.6% showed near–far disparity >10 ∆. Conclusion: The technique of combined resection–recession is safe, easy and more effective in the treatment of near-distance disparity esotropia regardless of the level of accommodative convergence/accommodation ratio, with stability of results though longer follow-up period is still needed. Keywords: near-distance disparity, esotropia, Ac/A ratio, retroequatorial myopexy, slanted recession

  20. Elevator Muscle Anterior Resection: A New Technique for Blepharoptosis.

    Science.gov (United States)

    Zigiotti, Gian Luigi; Delia, Gabriele; Grenga, Pierluigi; Pichi, Francesco; Rechichi, Miguel; Jaroudi, Mahmoud O; d'Alcontres, Francesco Stagno; Lupo, Flavia; Meduri, Alessandro

    2016-01-01

    Blepharoptosis is a condition of inadequate upper eyelid position, with a downward displacement of the upper eyelid margin resulting in obstruction of the superior visual field. Levator resection is an effective technique that is routinely used to correct aponeurotic ptosis. The anterior levator resection is the procedure of choice in moderate blepharoptosis when there is moderate to good levator muscle function, furthermore, with an anterior approach, a greater resection can be achieved than by a conjunctival approach. The authors describe a modification in the Putterman technique with a resection done over a plicated elevator, plication that was suggested by Mustardè. The technique has been named as elevator muscle anterior resection. The elevator muscle anterior resection inspires from the Fasanella-Servat operation by the use of a clamp, making the operation simple and predictable.

  1. Detailed anatomy of the abducens nerve in the lateral rectus muscle.

    Science.gov (United States)

    Nam, Yong Seok; Kim, In-Beom; Shin, Sun Young

    2017-10-01

    The aims of this study were to elucidate the detailed anatomy of the abducens nerve in the lateral rectus muscle (LRM) and the intramuscular innervation pattern using Sihler staining. In this cohort study, 32 eyes of 16 cadavers were assessed. Dissection was performed from the LRM origin to its insertion. The following distances were measured: from LRM insertion to the bifurcation point of the abducens nerve, from LRM insertion to the entry site of the superior branch or inferior branch, from the upper border of the LRM to the entry site of the superior branch, from the lower border of LRM to the entry site of inferior branch, and the widths of the main trunk and superior and inferior branches. The single trunk of the abducens nerve divided into two branches 37 mm from insertion of the LRM, and 22 of 32 (68.8%) orbits showed only two superior and inferior branches with no subdivision. The superior branch entered the LRM more anteriorly (P = 0.037) and the superior branch was thinner than the inferior branch (P = 0.040). The most distally located intramuscular nerve ending was observed at 52.9 ± 3.5% of the length of each muscle. Non-overlap between the superior and inferior intramuscular arborization of the nerve was detected in 27 of 32 cases (84.4%). Five cases (15.6%) showed definite overlap of the superior and inferior zones. This study revealed the detailed anatomy of the abducens nerve in the LRM and provides helpful information to understand abducens nerve palsy. Clin. Anat. 30:873-877, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  2. Surface electromyography activity of the rectus abdominis, internal oblique, and external oblique muscles during forced expiration in healthy adults.

    Science.gov (United States)

    Ito, Kenichi; Nonaka, Koji; Ogaya, Shinya; Ogi, Atsushi; Matsunaka, Chiaki; Horie, Jun

    2016-06-01

    We aimed to characterize rectus abdominis, internal oblique, and external oblique muscle activity in healthy adults under expiratory resistance using surface electromyography. We randomly assigned 42 healthy adult subjects to 3 groups: 30%, 20%, and 10% maximal expiratory intraoral pressure (PEmax). After measuring 100% PEmax and muscle activity during 100% PEmax, the activity and maximum voluntary contraction of each muscle during the assigned experimental condition were measured. At 100% PEmax, the external oblique (pinternal oblique (pexternal oblique (pinternal oblique (pexternal oblique: pinternal oblique: p<0.01). The abdominal oblique muscles are the most active during forced expiration. Moreover, 30% PEmax is the minimum intensity required to achieve significant, albeit very slight, muscle activity during expiratory resistance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. The effects of onabotulinum toxin A injection into rectus femoris muscle in hemiplegic stroke patients with stiff-knee gait: a placebo-controlled, nonrandomized trial.

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    Tok, Fatih; Balaban, Birol; Yaşar, Evren; Alaca, Rdvan; Tan, Arif Kenan

    2012-04-01

    This study aimed to compare the efficacy of onabotulinum toxin A (onabot) injection into the rectus femoris muscle with that of placebo in the treatment of hemiplegic stroke patients presenting with stiff-knee gait. Twenty-five chronic hemiparetic stroke patients presenting with a stiff-knee gait were included in this study. Fifteen patients received 100-125 U of onabot, and 10 patients received placebo into the rectus femoris muscle. Three-dimensional gait analysis, energy expenditure, 10-m and 6-min walk tests, and spasticity level of the rectus femoris were evaluated at baseline and 2 mos posttreatment. The mean age of patients who received onabot was 53.86 ± 14.74 yrs and of those who received placebo was 59.00 ± 8.11 yrs. At study onset, groups were similar with respect to all parameters (P > 0.05). We observed significant improvement in knee flexion (7 degrees average) during swing and a reduction in energy cost of 0.8-J/kg per meter response to injection of 100-125 U of onabot into the rectus femoris muscle. Onabot treatment significantly reduced muscle tone and improved knee kinematics, energy expenditure during walking, and functional assessments at 2 mos (P application of onabot into the rectus femoris muscle in stroke patients who presented with stiff-knee gait may be a treatment option to provide independent, safe, and less tiring ambulation.

  4. Reliability and validity of the ultrasound technique to measure the rectus femoris muscle diameter in older CAD-patients

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    Thomaes Tom

    2012-04-01

    Full Text Available Abstract Background The increasing age of coronary artery disease (CAD patients and the occurrence of sarcopenia in the elderly population accompanied by 'fear of moving' and hospitalization in these patients often results in a substantial loss of skeletal muscle mass and muscle strength. Cardiac rehabilitation can improve exercise tolerance and muscle strength in CAD patients but less data describe eventual morphological muscular changes possibly by more difficult access to imaging techniques. Therefore the aim of this study is to assess and quantify the reliability and validity of an easy applicable method, the ultrasound (US technique, to measure the diameter of rectus femoris muscle in comparison to the muscle dimensions measured with CT scans. Methods 45 older CAD patients without cardiac event during the last 9 months were included in this study. 25 patients were tested twice with ultrasound with a two day interval to assess test-retest reliability and 20 patients were tested twice (once with US and once with CT on the same day to assess the validity of the US technique compared to CT as the gold standard. Isometric and isokinetic muscle testing was performed to test potential zero-order correlations between muscle diameter, muscle volume and muscle force. Results An intraclass correlation coefficient (ICC of 0.97 ((95%CL: 0.92 - 0.99 was found for the test-retest reliability of US and the ICC computed between US and CT was 0.92 (95%CL: 0.81 - 0.97. The absolute difference between both techniques was 0.01 ± 0.12 cm (p = 0.66 resulting in a typical percentage error of 4.4%. Significant zero-order correlations were found between local muscle volume and muscle diameter assessed with CT (r = 0.67, p = 0.001 and assessed with US (r = 0.49, p Conclusions Ultrasound imaging can be used as a valid and reliable measurement tool to assess the rectus femoris muscle diameter in older CAD patients.

  5. Pedicled rectus abdominis muscle and fascia flap sling the bulbar urethra for treatment for male-acquired urinary incontinence: report of ten cases.

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    Xu, Yue-Min; Zhang, Xin-Ru; Xie, Hong; Song, Lu-Jie; Feng, Chao; Fei, Xiao-Fang

    2014-03-01

    Male urinary incontinence is relatively common complication of radical prostatectomy and of posterior urethroplasty following traumatic pelvic fracture. Here, we investigate the use of pedicled rectus abdominis muscle and fascia flap sling of the bulbar urethra for treatment for male-acquired urinary incontinence. Ten patients with acquired urinary incontinence were included in the study. Urinary incontinence was secondary to TURP in three patients and was secondary to posterior urethroplasty performed following traumatic pelvic fracture in seven patients. Pedicled rectus abdominalis muscle and fascial flaps, approximately 2.5 cm wide and 15 cm long, were isolated. The flaps were inserted into a perineal incision through a subcutaneous tunnel. The free end of the flap was sectioned to form two muscle strips, each 3 cm in length, and inserted into the space between bulbar urethra and corpus cavernosa. After adequate sling tension had been achieved, the two strips of muscle were anastomosed around the bulbar urethra using a 2-zero polyglactin suture. The patients were followed up for between 12 and 82 months (mean 42.8 months). Complete continence was achieved with good voiding in seven of the 10 patients. In other three patients achieved good voiding following catheter removal, but incontinence was only moderately improved. A pedicled rectus muscle fascial sling of the bulbar urethra is an effective and safe treatment for male patients with mild to moderate acquired urinary incontinence, but it may not be suitable for severe incontinence or for patients with weak rectus abdominalis muscles.

  6. Efficiency of Medial Rectus Advancement Surgery in Consecutive Exotropia

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    Kemal Yar

    2015-12-01

    Full Text Available Purpose: To evaluate the efficiency of medial rectus advancement surgery in consecutive exotropia. Material and Methods: The study group consisted of 20 cases, 10 male, 10 female, who were diagnosed as consecutive exotropia and underwent surgery between 2008-2013 at Cukurova University Medical Faculty Ophthalmology Department. Records of the patients were investigated retrospectively. We evaluated best corrected visual acuity, existence of ambliopia, postoperative duration following the first surgery and applied surgical procedures. Postoperative deviation lower than 10 PD were assesed as successful. Mean follow up period was 29,8 +/- 21,36 (8-80 months, patients with inadequate follow up period were dismissed from the study group. Results: We only applied bilateral medial rectus advancement surgery to 6 and unilateral medial rectus advancement surgery to 5 patients and obtained intended surgical result in these 11 cases. The other patients underwent lateral rectus recession or/and medial rectus resection operations inorder to reach projected deviation degrees. Deviation was found to be 46,4+/-9,24 (40-70 PD in cases who only underwent advancement surgery and was 65,56 +/- 18,78 (40-90 PD in cases who underwent additional surgical procedure. 16 (%80 of the cases had hypermetropi various dioptries and 7 (%35 had ambliopia. Discussion: Consecutive exotropia can appear years after surgery and is an important late period complication. In this study achievement of %55 success with medial rectus advancement surgery indicates that this is a preferable procedure. But in wide angle deviations additional lateral rectus recession or/and medial rectus resection operations can be applied inorder to reach intended adjustment. Accurrate prediction of the propotion of advancement surgery and adjustment is not always possible because of intensive fybrosis in operated muscles and enviroment tissue. [Cukurova Med J 2015; 40(4.000: 707-713

  7. Clear Cell Adenocarcinoma Arising from Endometriosis in the Groin: Wide Resection and Reconstruction with a Fascia Lata Tensor Muscle Skin Flap

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    Shozo Yoshida

    2018-01-01

    Full Text Available We herein report a case of clear cell carcinoma arising from endometriosis in the groin in a 53-year-old woman. The findings of MRI and FDG/PET-CT indicated a malignant tumor, and surgical biopsy confirmed adenocarcinoma of the female genital tract. The tumor including a part of the abdominal rectus muscle and rectus sheath, subcutaneous fat, skin, and the right inguinal ligament was resected en bloc. The defect in the abdominal wall was reconstructed with a fascia lata tensor muscle skin flap. The tumor was composed of clear cell adenocarcinoma arising from extrapelvic endometriosis. The patient received chemotherapy with gemcitabine and carboplatin for 6 cycles and had no evidence of recurrence 7 months after the treatment. We herein described the diagnosis and surgical management of endometriosis-associated carcinoma in the groin.

  8. [Contralateral Recession of the Inferior Oblique Muscle in Grave's Disease Patients with Mild M. rectus inferior fibrosis].

    Science.gov (United States)

    Eckstein, A; Raczynski, S; Dekowski, D; Esser, J

    2015-10-01

    The aim of this study was to evaluate the dose effect and the resulting binocular single vision for inferior oblique muscle recession in patients with Grave's orbitopathy. The evaluation covered all patients (n = 13) between 2010-2013 treated with recession of the inferior oblique muscle for vertical deviation caused by inferior fibrosis of the contralateral eye. The inclusion criterion was a small vertical squint angle with excyclotorsion. The corrected vertical squint angle was 3.75° [7 pdpt] (median, min 1.5° [3 pdpt], max 8° [16 pdpt]) in primary position and 5.5° in adduction [11pdpt] (median, min 3°[6 pdpt], max 9°[18pdpt]). Excyclotorsion was 4° [8 pdpt] (median, min 1° [2 pdpt], max 9° [18 pdpt]). Elevation was only slightly impaired and the side difference was 5° (median). The recession distance was preoperatively determined: 0.5° squint angle reduction per mm recession distance (calculation from patients who received surgery before 2010). Inferior oblique recession generated a good field of binocular single vision (BSV) for all patients. All patients reached BSV in the central area (20°) and within 30° of downgaze. Sixty nine percent of the patients were completely diplopia free in downgaze. Diplopia persisted in more than half of the patients in up gaze outside 15°. Squint reduction was 0.5° [1 pdpt] [0.45-0.67]/per mm recession distance in primary position and 0.65° [1.3 pdpt] [0.55-0.76]/per mm for the vertical deviation in adduction. Excyclotorsion was reduced to ≤ 2° in 77 % of the patients. Inferior oblique muscle recession can be very successfully performed on the contralateral eye in patients with mild inferior rectus muscle fibrosis. Surgery at the contralateral yoke muscle prevents the risk of overeffect with resulting diplopia in downgaze, which could occur if small distance recession had been performed at the inferior rectus muscle. An overeffect in relation to inferior oblique recession will only

  9. Anatomical and Physiological Characteristics of the Ferret Lateral Rectus Muscle and Abducena Nucleus

    Science.gov (United States)

    2007-01-25

    from the ferret LR Slow Resistant group is larger than the typically powerful Fast Fatigable motor units in the cat. Whole Muscle Contractile...623-632, 1990. 21. HESS A and PILAR G. SLOW FIBRES IN THE EXTRAOCULAR MUSCLES OF THE CAT. J Physiol 169: 780-798, 1963. 22. Jacoby J, Chiarandini DJ...were split between the LR and retractor bulbi (RB) muscle slips. In addition to individual motor units, the whole LR muscle was evaluated for twitch

  10. Ultrasound diagnosis of rectus sheath hematoma

    International Nuclear Information System (INIS)

    Hwang, M. S.; Chang, J. C.; Rhee, C. B.

    1984-01-01

    6 cases of rectus sheath hematoma were correctly diagnosed by ultrasound. 2 cases had bilateral rectus sheath hematoma and 4 cases were unilateral. On ultrasound finding, relatively well defined oval or spindle like cystic mass situated in the area of rectus muscle on all cases. Ultrasound examination may give more definite diagnosis and extension rectus sheath hematoma and also helpful to follow up study of hematoma

  11. Evaluation of rectus extraocular muscles using dynamic contrast-enhanced MR imaging in patients with Graves' ophthalmopathy for assessment of disease activity

    International Nuclear Information System (INIS)

    Jiang, Hong; Wang, Zhenchang; Xian, Junfang; Li, Jing; Chen, Qinghua; Ai, Likun

    2012-01-01

    Background. It is important to assess the activity of Graves' ophthalmopathy (GO) for planning optimal treatment strategy. Dynamic contrast-enhanced MR imaging (DCE-MRI) is a technique for assessment of microcirculation status. The correlation between disease activity and the microcirculation characteristics of extraocular muscles (EOMs) has been demonstrated in GO. Purpose. To investigate the changes of rectus EOMs in patients with active vs. inactive GO using DCE-MRI, and to evaluate the value of DCE-MRI in assessing the activity of GO. Material and Methods. Rectus EOMs of 20 healthy controls, 18 patients with active GO, and 16 patients with inactive GO were studied. The signal intensity (SI) of rectus EOMs on T 2 W images was evaluated. Regions of interest were placed on each rectus on DCE-MRI images. The DCE-MRI parameters including time to peak enhancement (T peak ), enhancement ratio (ER), and wash-out ratio (WR) were calculated. Results. There were significant differences in SI and T peak , ER and WR values among the three groups (P = 0.000). However, there was no significant difference in SI between the active and inactive groups (P = 0.07). Tpeak values of each rectus were significantly increased in inactive group compared with the active group (P peak ), maximum ER (maxER) and maximum WR (maxWR) (P peak , maxER and maxWR were 156.98s, 1.31 and 13.50% respectively, giving positive predictive values of 68.00%, 88.90%, and 94.44% for the assessment of disease activity. Conclusion. DCE-MRI could demonstrate the micro circulatory changes of rectus EOMs in both active and inactive GO, and this MRI method is a useful tool in differentiating active from inactive GO

  12. [Electrocoagulation on a fragment of anterior abdominal rectal muscle for the control of presacral bleeding during rectal resection].

    Science.gov (United States)

    Casal Núñez, José Enrique; Martínez, María Teresa García; Poblador, Alejandro Ruano

    2012-03-01

    Presacral venous haemorrhage during rectal movement is low, but is often massive, and even fatal. Our objective is the "in vitro" determination of the results of electrocoagulation applied to a fragment of muscle on the sacral bone surface during rectal resection due to a malignant neoplasm of the rectum. Single-pole coagulation was applied "in vitro" with the selector at maximum power on a 2×2 cms muscle fragment, applied to the anterior side of the IV sacral vertebra until reaching boiling point. The method was used on 6 patients with bleeding of the presacral venous plexus. In the "in vitro" study, boiling point was reached in 90 seconds from applying the single-pole current on the muscle fragment. Electrocoagulation was applied to a 2×2 cm rectal muscle fragment in 6 patients with presacral venous haemorrhage, using pressure on the surface of the presacral bone, with the stopping of the bleeding being achieved in all cases. The use of indirect electrocoagulation on a fragment of the rectus abdominis muscle is a straightforward and highly effective technique for controlling presacral venous haemorrhage. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

  13. Comparison of results of medial rectus muscle recession using augmentation, Faden procedure, and slanted recession in the treatment of high accommodative convergence/accommodation ratio esotropia.

    Science.gov (United States)

    Gharabaghi, Davoud; Zanjani, Leila Kazemi

    2006-01-01

    According to the literature, accommodative esotropia has an unpredictable course when nonsurgical treatment is considered, especially in cases with a high accommodative convergence/accommodation ratio (AC/A). The aim of this study was to compare the results of augmented recession, slanted recession, and recession with posterior fixation suture of the medial rectus muscles in the treatment of high AC/A esotropia. Twenty-eight children (4 to 14 years old) with high AC/A esotropia with a near-distance disparity greater than 10 PD were included in a prospective, randomized, blinded clinical trial. Nine children underwent recession of both medial rectus muscles and posterior fixation suture (Faden procedure), 9 children underwent augmented recession of the medial rectus muscles, and 10 children underwent slanted recession of both medial rectus muscles. The amount of esodeviation was measured before strabismus surgery and at least 6 months postoperatively. In the augmented recession group, the mean near-distance disparity was reduced from 16.33 +/- 2.17 PD preoperatively to 7.55 +/- 3.87 PD postoperatively (54.21%; P = .056). In the Faden procedure group, it was reduced from 15.22 +/- 4.08 PD to 2.55 +/- 4.03 PD (80.7%; P = .056). In the slanted recession group, it was reduced from 15.50 +/- 4.30 PD to 4.10 +/- 4.80 PD (67.55%; P = .056). The Faden procedure had the best outcome, but slanted recession also was successful. Because of our good results and an easy, non-invasive approach without any additional complications, we recommend slanted recession to treat high AC/A esotropia.

  14. Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache: a pilot study.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cuadrado, María Luz; Arendt-Nielsen, Lars; Ge, Hong-You; Pareja, Juan A

    2008-03-01

    To investigate whether cross-sectional area (CSA) of the suboccipital muscles was associated with active trigger points (TrPs) in chronic tension-type headache (CTTH). Magnetic resonance imaging (MRI) of the cervical spine was performed in 11 females with CTTH aged from 26 to 50 yrs old. CSA for both rectus capitis posterior minor (RCPmin) and rectus capitis posterior major (RCPmaj) muscles were measured from axial T1-weighted images, using axial MRI slices aligned parallel to the C2/3 intervertebral disc. A headache diary was kept for 4 wks to record the pain history. TrPs in the suboccipital muscle were identified by eliciting referred pain to palpation, and increased referred pain with muscle contraction. TrPs were considered active if the elicited referred pain reproduced the head pain pattern and features of the pattern seen during spontaneous headache attacks. Active TrPs were found in six patients (55%), whereas the remaining five patients showed latent TrPs. CSA of the RCPmin was significantly smaller (F = 13.843; P = 0.002) in the patients with active TrPs (right side: 55.9 +/- 4.4 mm; left side: 61.1 +/-: 3.8 mm) than in patients with latent TrPs (right side: 96.9 +/- 14.4 mm; left side: 88.7 +/- 9.7 mm). No significant differences were found for CSA of the RCPmaj between the patients with either active or latent TrP (P > 0.5). It seems that muscle atrophy in the RCPmin, but not in the RCPmaj, was associated with suboccipital active TrPs in CTTH, although studies with larger sample sizes are now required. It may be that nociceptive inputs in active TrPs could lead to muscle atrophy of the involved muscles. Muscle disuse or avoidance behavior can also be involved in atrophy.

  15. Rectus sheath abscess after laparoscopic appendicectomy

    Directory of Open Access Journals (Sweden)

    Golash Vishwanath

    2007-01-01

    Full Text Available Port site wound infection, abdominal wall hematoma and intraabdominal abscess formation has been reported after laparoscopic appendicectomy. We describe here a rectus sheath abscess which occurred three weeks after the laparoscopic appendicectomy. It was most likely the result of secondary infection of the rectus sheath hematoma due to bleeding into the rectus sheath from damage to the inferior epigastric arteries or a direct tear of the rectus muscle. As far as we are aware this complication has not been reported after laparoscopic appendicectomy.

  16. Retroperitoneal and rectus sheath hematomas.

    Science.gov (United States)

    Kasotakis, George

    2014-02-01

    The retroperitoneum is rich in vascular structures and can harbor large hematomas, traumatic or spontaneous. The management of retroperitoneal hematomas depends on the mechanism of injury and whether they are pulsatile/expanding. Rectus sheath hematomas are uncommon abdominal wall hematomas secondary to trauma to the epigastric arteries of the rectus muscle. The common risk factors include anticoagulation, strenuous exercise, coughing, coagulation disorders, and invasive procedures on/through the abdominal wall. The management is largely supportive, with the reversal of anticoagulation and transfusions; angioembolization may be necessary. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Resecting orbicularis oculi muscle in upper eyelid blepharoplasty - A review of the literature

    NARCIS (Netherlands)

    Hoorntje, Lidewij E.; van der Lei, Berend; Stollenwerck, Guido A.; Kon, Moshe

    Background: Blepharoplasty of the upper eyelids is one of the most commonly performed procedures in aesthetic plastic surgery. However, the rationale for muscle resection along with skin is uncertain. Methods: A PubMed search was performed using the following keywords: 'blepharoplasty' and 'muscle'

  18. Functional deltoid muscle reconstruction following an extensive squamous cell carcinoma resection

    Directory of Open Access Journals (Sweden)

    Tang Weng Jun

    2016-07-01

    Full Text Available Squamous cell carcinoma frequently occurs in an individual with albinism. In this case, the growth of the squamous cell carcinoma was aggressive that it invaded the deltoid muscle. After an oncologic resection, there was a huge defect which required near total resection of the deltoid muscle. Loss of deltoid muscle will lead to the loss of abduction and anterior flexion at the shoulder. This could be debilitating in a person’s normal daily life and activities. Restoration of the shoulder abduction and flexion function with a pedicle bipolar latissimus dorsi flap transfer was chosen in this case due to the versatility and reliability of the flap.

  19. Mandibular angle resection and masticatory muscle hypertrophy - a technical note and morphological optimization.

    Science.gov (United States)

    Andreishchev, A R; Nicot, R; Ferri, J

    2014-11-01

    Mandibular angle resection is rarely used, but is a highly effective means of correcting facial defects. We report a mandibular angle resection technique associated with the removal of a part of hypertrophic masseter muscles and resection of buccal fat pad. Anatomical reminders: the most important entities are the facial artery and vein, crossing the lower margin of the jaw just in front of the anterior boarder of the masseter muscle and the temporomaxillary vein, passing through the temporomaxillary fossa; preoperative aspects: the preoperative examination included a radiological assessment of the shape and size of the mandibular angle; surgical technique: an intra-oral approach was usually used. The most effective and convenient method for the osteotomy was using a reciprocating saw. This technique allowed achieving a smooth contour of masseter muscles during masticatory movements or at rest. Eleven mandibular angle resections were performed from 2001 to 2009. The surgery was supplemented by remodeling the lower margin of the jaw for 5 other patients. No permanent facial palsy was noted. One patient presented a unilateral long-term loss of sensitivity of the lower lip and chin. This surgical technique if simple even requires using good technical equipment, and observing a set of rules. Using these principles allows simplifying the surgical technique, and decreasing its morbidity. A part of the masseter muscles and the buccal fat pad can sometimes be resected to improve the morphological results. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. CT, Magnetic Resonance, and {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/CT Imaging Features of Mucosa-Associated Lymphoid Tissue Lymphoma Involving Medial Rectus Muscle: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Kwon; Choe, Mi Sun [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-06-15

    We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma involving the medial rectus muscle in a 47-year-old man along with CT, MRI, 18 F-fluorodeoxy-glucose positron emission tomography/CT ( 18 F-FDG PET/CT), and pathologic features. The lesion was manifested as a fusiform enlargement isolated to the right medial rectus muscle with involvement of its tendinous insertion. The lesion was isoattenuating to the brain on non-enhanced CT images, showing as isointense to gray matter on fast spin echo T1- and T2-weighted images with fat saturation, and showed homogeneous enhancement on contrast-enhanced CT and MR images. The maximum stan- dardized uptake value on 18 F-FDG PET/CT was 4.9 g/mL. The results of histological and immunohistochemical examinations of the specimen obtained by biopsy of the right medial rectus muscle were consistent with MALT lymphoma. It should be noted that the extraocular muscle (EOM) is a rare location for the involvement of MALT lympho- ma, and MALT lymphoma of the EOM may mimic thyroid orbitopathy.

  1. CT, Magnetic Resonance, and 18F-Fluorodeoxyglucose Positron Emission Tomography/CT Imaging Features of Mucosa-Associated Lymphoid Tissue Lymphoma Involving Medial Rectus Muscle: A Case Report

    International Nuclear Information System (INIS)

    Lee, Sang Kwon; Choe, Mi Sun

    2013-01-01

    We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma involving the medial rectus muscle in a 47-year-old man along with CT, MRI, 18 F-fluorodeoxy-glucose positron emission tomography/CT ( 18 F-FDG PET/CT), and pathologic features. The lesion was manifested as a fusiform enlargement isolated to the right medial rectus muscle with involvement of its tendinous insertion. The lesion was isoattenuating to the brain on non-enhanced CT images, showing as isointense to gray matter on fast spin echo T1- and T2-weighted images with fat saturation, and showed homogeneous enhancement on contrast-enhanced CT and MR images. The maximum stan- dardized uptake value on 18 F-FDG PET/CT was 4.9 g/mL. The results of histological and immunohistochemical examinations of the specimen obtained by biopsy of the right medial rectus muscle were consistent with MALT lymphoma. It should be noted that the extraocular muscle (EOM) is a rare location for the involvement of MALT lympho- ma, and MALT lymphoma of the EOM may mimic thyroid orbitopathy.

  2. Rectus sheath hematoma: three case reports

    Directory of Open Access Journals (Sweden)

    Kapan Selin

    2008-01-01

    Full Text Available Abstract Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.

  3. Combined lateral rectus augmented transposition and inferior rectus recession for monocular elevation deficiency.

    Science.gov (United States)

    Jayakumar, Manjula; Kumar, Dhivya Ashok; Agarwal, Amar

    2018-04-01

    We report the case of a 21-year-old woman who presented with a drooping right upper eyelid and smaller-appearing right eye, evident since birth. Her visual acuity was 20/30 in the right eye and 20/20 in the left eye. In primary gaze she had a hypotropia of 25 Δ , with a marked elevation limitation and associated true upper lid ptosis of 3 mm. Under local anesthesia, the lateral rectus muscle was transposed to the superior rectus muscle and was augmented by a nonabsorbable suture attaching the superior rectus muscle and lateral rectus muscle 8 mm posterior to the insertion, accompanied by an inferior rectus recession. One year after surgery she was orthophoric in primary position and showed improvement in elevation. The surgical procedure can be performed at the same time as the inferior rectus recession and reduces the risk of anterior segment ischemia. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  4. Long-term Outcomes After Same Amount of Bilateral Rectus Muscle Recession for Intermittent Exotropia With the Same Angle of Deviation.

    Science.gov (United States)

    Lee, Haeng-Jin; Kim, Seong-Joon; Yu, Young Suk

    2018-06-18

    To evaluate long-term outcomes of homogenous bilateral rectus recession in patients with the same preoperative angle of deviation in intermittent exotropia and investigate factors associated with surgical outcomes. In this retrospective review, patients with the same preoperative angle of deviation who underwent bilateral 6-mm lateral rectus recession between January 2008 and January 2014 were observed for 2 or more years. Patients were classified into two groups based on deviation angle: success (orthophoria or exodeviation XXXX.]. Copyright 2018, SLACK Incorporated.

  5. Debilitamiento bilateral de los músculos rectos medios en esotropías parcialmente acomodativas Bilateral attenuation of medial rectus muscles in partially accommodative esotropia

    Directory of Open Access Journals (Sweden)

    María Emilia Fernández González

    2009-12-01

    Full Text Available Se realizó una investigación descriptiva, transversal y prospectiva de 13 pacientes con isotropía parcialmente acomodativa, después de una corrección total de la hipermetropía, tratados en el Servicio de Oftalmología del Policlínico Pediátrico Sur de Santiago de Cuba desde mayo del 2006 hasta septiembre del 2008. La ejecución de este estudio se justificó por el insuficiente conocimiento existente sobre el alineamiento ocular en las endotropías parcialmente acomodativas, luego de aplicar la técnica de debilitamiento bilateral de los músculos rectos medios. En la serie estudiada, la edad media fue de 6,3 años y el alineamiento ocular logrado en el período posoperatorio resultó exitoso, además de que no estuvo relacionado con la ametropía. La ambliopía encontrada contribuyó al pronóstico de la afección.A descriptive, cross-sectional and prospective investigation of 13 patients with partially accommodative esotropia was carried out, after a total correction of the hypermetropy, treated in the Ophthalmology Service of the Southern Pediatric Polyclinic of Santiago de Cuba from May, 2006 to September, 2008. The implementation of this study was justified for the insufficient existent knowledge on the ocular alignment in the partially accommodative endotropia, after applying the technique of bilateral attenuation of medial rectus muscles. In the studied series, the mean age was of 6,3 years and the ocular alignment achieved in the posoperative period was successful besides that was not related with the ametropia. The amblyopia found contributed to the prognosis of the disorder.

  6. Measurement methods to assess diastasis of the rectus abdominis muscle (DRAM): A systematic review of their measurement properties and meta-analytic reliability generalisation.

    Science.gov (United States)

    van de Water, A T M; Benjamin, D R

    2016-02-01

    Systematic literature review. Diastasis of the rectus abdominis muscle (DRAM) has been linked with low back pain, abdominal and pelvic dysfunction. Measurement is used to either screen or to monitor DRAM width. Determining which methods are suitable for screening and monitoring DRAM is of clinical value. To identify the best methods to screen for DRAM presence and monitor DRAM width. AMED, Embase, Medline, PubMed and CINAHL databases were searched for measurement property studies of DRAM measurement methods. Population characteristics, measurement methods/procedures and measurement information were extracted from included studies. Quality of all studies was evaluated using 'quality rating criteria'. When possible, reliability generalisation was conducted to provide combined reliability estimations. Thirteen studies evaluated measurement properties of the 'finger width'-method, tape measure, calipers, ultrasound, CT and MRI. Ultrasound was most evaluated. Methodological quality of these studies varied widely. Pearson's correlations of r = 0.66-0.79 were found between calipers and ultrasound measurements. Calipers and ultrasound had Intraclass Correlation Coefficients (ICC) of 0.78-0.97 for test-retest, inter- and intra-rater reliability. The 'finger width'-method had weighted Kappa's of 0.73-0.77 for test-retest reliability, but moderate agreement (63%; weighted Kappa = 0.53) between raters. Comparing calipers and ultrasound, low measurement error was found (above the umbilicus), and the methods had good agreement (83%; weighted Kappa = 0.66) for discriminative purposes. The available information support ultrasound and calipers as adequate methods to assess DRAM. For other methods limited measurement information of low to moderate quality is available and further evaluation of their measurement properties is required. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Comparative study on conjoint fascial sheath suspension and levator muscle resection for moderate or severe congenital ptosis

    Directory of Open Access Journals (Sweden)

    Wei Lin

    2016-06-01

    Full Text Available AIM:To compare the curative effect of conjoint fascial sheath(CSFsuspension and levator muscle resection for moderate or severe congenital ptosis. METHODS: Forty-three patients(74 eyeswith moderate or severe ptosis were treated by CSF suspension or levator muscle resection randomly, and followed up for 6mo. The normalization rates of the two operations were then compared by statistical method, and the complications of the two operations were analyzed.RESULTS: The two operations appeared no significant difference on the normalization rate for moderate congenital ptosis(P>0.05, while the normalization rate of CSF suspension on severe congenital ptosis was significantly higher than that of levator muscle resection(PCONCLUSION: CSF suspension is more effective on the treatment of severe congenital ptosis than levator muscle resection, and has advantages such as less trauma, repeatable, and less complication.

  8. Comparative study on conjoint fascial sheath suspension and levator muscle resection for moderate or severe congenital ptosis

    OpenAIRE

    Wei Lin; Yang Xu; Fei-Lun Ye

    2016-01-01

    AIM:To compare the curative effect of conjoint fascial sheath(CSF)suspension and levator muscle resection for moderate or severe congenital ptosis. METHODS: Forty-three patients(74 eyes)with moderate or severe ptosis were treated by CSF suspension or levator muscle resection randomly, and followed up for 6mo. The normalization rates of the two operations were then compared by statistical method, and the complications of the two operations were analyzed.RESULTS: The two operations appeared no ...

  9. Rectus Abdominis Endometrioma after Caesarean Section

    Directory of Open Access Journals (Sweden)

    Igor Mishin

    2016-01-01

    Full Text Available Isolated rectus abdominis muscle endometriosis is very uncommon with less than 20 case reports being published to date since its first description in 1984 by Amato and Levitt. We report another case of isolated rectus abdominis endometriosis in a 37-year-old patient with a previous caesarian section. We also discuss the diagnostic and treatment particularities in these patients. In our case, the treatment was only surgical and currently the patient is disease-free during the 24-month follow-up.

  10. Superior Oblique Anterior Transposition with Horizontal Recti Recession-Resection for Total Third-Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Muhsin Eraslan

    2015-01-01

    Full Text Available Aims. To report the results of lateral rectus muscle recession, medial rectus muscle resection, and superior oblique muscle transposition in the restoration and maintenance of ocular alignment in primary position for patients with total third-nerve palsy. Methods. The medical records of patients who underwent surgery between March 2007 and September 2011 for total third-nerve palsy were reviewed. All patients underwent a preoperative assessment, including a detailed ophthalmologic examination. Results. A total of 6 patients (age range, 14–45 years were included. The median preoperative horizontal deviation was 67.5 Prism Diopter (PD (interquartile range [IQR] 57.5–70 and vertical deviation was 13.5 PD (IQR 10–20. The median postoperative horizontal residual exodeviation was 8.0 PD (IQR 1–16, and the vertical deviation was 0 PD (IQR 0–4. The median correction of hypotropia following superior oblique transposition was 13.5 ± 2.9 PD (range, 10–16. All cases were vertically aligned within 5 PD. Four of the six cases were aligned within 10 PD of the horizontal deviation. Adduction and head posture were improved in all patients. All patients gained new area of binocular single vision in the primary position after the operation. Conclusion. Lateral rectus recession, medial rectus resection, and superior oblique transposition may be used to achieve satisfactory cosmetic and functional results in total third-nerve palsy.

  11. Smooth muscle enfoldment internal sphincter construction after intersphincteric resection for rectal cancer.

    Directory of Open Access Journals (Sweden)

    Heiying Jin

    Full Text Available To assess smooth muscle enfoldment and internal sphincter construction (SMESC for improvement of continence after intersphincteric resection (ISR for rectal cancer.Twenty-four Bama miniature pigs were randomly divided into a conventional ISR group and experimental SMESC group, with 12 pigs in each group. The proximal sigmoid colon was anastomosed directly to the anus in the ISR group. In the SMESC group, internal sphincter construction was performed. At 12 weeks before and after surgery, rectal resting pressure and anal canal length were assessed. Three-dimensional ultrasound was used to determine the thickness of the internal sphincter. After the animals were sacrificed, the rectum and anus were resected and pathological examinations were performed to evaluate the differences in sphincter thickness and muscle fibers.All 24 animals in the SMESC group and the ISR group survived the surgery. Twelve weeks post-surgery, the rectal resting pressure, length of the anal high-pressure zone and the postoperative internal sphincter thickness for the ISR group were significantly lower than for the SMESC group. There was a thickened area (about 2 cm above the anastomotic stoma among animals from the SMESC group; in addition, the smooth muscles were significantly enlarged and enfolded when compared to the ISR group.This animal model study shows that the SMESC procedure achieved acceptable reconstruction of the internal anal neo-sphincter (IAN/S, without increasing surgical risk. However, the findings in this experimental animal model must be confirmed by clinical trials to determine the safety and efficacy of this procedure in clinical practice.

  12. Smooth muscle enfoldment internal sphincter construction after intersphincteric resection for rectal cancer.

    Science.gov (United States)

    Jin, Heiying; Zhang, Bei; Yao, Hang; Du, Yonghong; Wang, Xiaofeng; Leng, Qiang

    2014-01-01

    To assess smooth muscle enfoldment and internal sphincter construction (SMESC) for improvement of continence after intersphincteric resection (ISR) for rectal cancer. Twenty-four Bama miniature pigs were randomly divided into a conventional ISR group and experimental SMESC group, with 12 pigs in each group. The proximal sigmoid colon was anastomosed directly to the anus in the ISR group. In the SMESC group, internal sphincter construction was performed. At 12 weeks before and after surgery, rectal resting pressure and anal canal length were assessed. Three-dimensional ultrasound was used to determine the thickness of the internal sphincter. After the animals were sacrificed, the rectum and anus were resected and pathological examinations were performed to evaluate the differences in sphincter thickness and muscle fibers. All 24 animals in the SMESC group and the ISR group survived the surgery. Twelve weeks post-surgery, the rectal resting pressure, length of the anal high-pressure zone and the postoperative internal sphincter thickness for the ISR group were significantly lower than for the SMESC group. There was a thickened area (about 2 cm) above the anastomotic stoma among animals from the SMESC group; in addition, the smooth muscles were significantly enlarged and enfolded when compared to the ISR group. This animal model study shows that the SMESC procedure achieved acceptable reconstruction of the internal anal neo-sphincter (IAN/S), without increasing surgical risk. However, the findings in this experimental animal model must be confirmed by clinical trials to determine the safety and efficacy of this procedure in clinical practice.

  13. Tear function and ocular surface after Muller muscle-conjunctival resection.

    Science.gov (United States)

    Uğurbaş, Suat Hayri; Alpay, Atilla; Bahadır, Burak; Uğurbaş, Sılay Cantürk

    2014-05-01

    Muller muscle-conjunctival resection (MCR) is a surgical technique to correct mild and moderate ptosis. In this study, tear function tests and ocular surface are evaluated in patients who underwent unilateral surgery. Sixteen patients with normal preoperative tear function who underwent unilateral MCR were evaluated prospectively. The fellow eyes of the patients were taken as the control group. A dry eye assessment questionnaire, Schirmer testing, tear film break-up time, fluorescein stain, Rose-Bengal stain, and conjunctival impression cytology were used to assess the tear film functions and ocular surface changes in the operated and non-operated eyes. There was no statistically significant difference in the tear function tests and goblet cell densities between the operated and non-operated eyes. The results indicate that an MCR procedure has no apparent effect on tear function tests and goblet cell density in patients with normal preoperative tear function.

  14. Adesivo biológico de fibrina na mioescleropexia posterior em coelhos: estudo experimental Fibrin biological adhesive for posterior mioscleral fixation of superior rectus muscles: an experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Ana Tereza Ramos Moreira

    2004-04-01

    Full Text Available OBJETIVOS: 1. Verificar a capacidade de cola do adesivo biológico de fibrina quando utilizado para reduzir o arco de contato do músculo reto superior com a esclera de coelhos. 2. Comparar a redução da função do músculo reto superior tratado com a função do músculo reto superior contralateral, utilizado como controle. MÉTODOS: A amostra foi constituída por 30 coelhos, 60 olhos. Em cada coelho, realizou-se mioescleropexia posterior com adesivo biológico em um dos olhos (30 olhos, enquanto o outro serviu como controle (30 olhos. Todos os animais foram sacrificados após 60 dias pós-operatórios. Avaliaram-se a hipofunção muscular e o tamanho da aderência mioescleral produzida imediatamente pela cirurgia e após 60 dias. RESULTADOS: O coágulo de fibrina formou-se imediatamente à sua aplicação no músculo, e as fibras musculares apresentaram-se aderidas em poucos segundos à esclera. Todos os olhos operados com adesivo bio-lógico de fibrina demonstraram hipofunção muscular após 60 dias, quando comparada ao músculo contralateral. O tamanho do coágulo formado inicialmente, relacionado às medidas obtidas após 60 dias, demonstrou uma porcentagem de redução de 28,48% e uma correlação ascendente e positiva (r=0,367204, porém fraca, elucidando a existência de múltiplas variáveis influenciando nessa redução. Não houve sinais de hiperemia, secreção conjuntival, ou qualquer outra complicação atribuída à cirurgia, ao final de 60 dias. CONCLUSÃO: O adesivo biológico de fibrina provoca adesão músculo-escleral, encurtando o arco de contato, ocasionando a hipofunção desejada. A aplicação do adesivo facilita a mioescleropexia posterior, evitando a possibilidade de perfuração ocular.PURPOSES: 1. To evaluate the adhesion capacity of the fibrin biological adhesive in surgery of posterior fixation of the superior rectus muscle, when it is used for the reduction of the arc of contact. 2. To compare the reduction of

  15. Muscle invasive bladder cancer treated by transurethral resection, followed by external beam radiation and interstitial iridium-192

    NARCIS (Netherlands)

    A. Wijnmaalen (Arendjan); P.A. Helle (Peter); P.C.M. Koper (Peter); P.P. Jansen (Peter); P. Hanssens (Patrick); C.G.G. Boeken Kruger (Cornelis); W.L.J. van Putten (Wim)

    1997-01-01

    textabstractPurpose: To evaluate the results of transurethral resection (TUR), external beam radiotherapy (EBRT), and interstitial radiation (IRT) with iridium-192, using the afterloading technique in patients with muscle invasive bladder cancer. Methods and Materials: From May 1989 until September

  16. Adaptability of the Immature Ocular Motor Control System: Unilateral IGF-1 Medial Rectus Treatment.

    Science.gov (United States)

    Willoughby, Christy L; Fleuriet, Jérome; Walton, Mark M; Mustari, Michael J; McLoon, Linda K

    2015-06-01

    Unilateral treatment with sustained release IGF-1 to one medial rectus muscle in infant monkeys was performed to test the hypothesis that strabismus would develop as a result of changes in extraocular muscles during the critical period of development of binocularity. Sustained release IGF-1 pellets were implanted unilaterally on one medial rectus muscle in normal infant monkeys during the first 2 weeks of life. Eye position was monitored using standard photographic methods. After 3 months of treatment, myofiber and neuromuscular size, myosin composition, and innervation density were quantified in all rectus muscles and compared to those in age-matched controls. Sustained unilateral IGF-1 treatments resulted in strabismus for all treated subjects; 3 of the 4 subjects had a clinically significant strabismus of more than 10°. Both the treated medial rectus and the untreated ipsilateral antagonist lateral rectus muscles had significantly larger myofibers. No adaptation in myofiber size occurred in the contralateral functionally yoked lateral rectus or in myosin composition, neuromuscular junction size, or nerve density. Sustained unilateral IGF-1 treatment to extraocular muscles during the sensitive period of development of orthotropic eye alignment and binocularity was sufficient to disturb ocular motor development, resulting in strabismus in infant monkeys. This could be due to altering fusion of gaze during the early sensitive period. Serial measurements of eye alignment suggested the IGF-1-treated infants received insufficient coordinated binocular experience, preventing the establishment of normal eye alignment. Our results uniquely suggest that abnormal signaling by the extraocular muscles may be a cause of strabismus.

  17. Dengue fever with rectus sheath hematoma: A case report

    Directory of Open Access Journals (Sweden)

    Anurag Sharma

    2014-01-01

    Full Text Available Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear.

  18. Imaging of rectus femoris proximal tendinopathies

    International Nuclear Information System (INIS)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu; Sonnery-Cottet, Bertrand; Graveleau, Nicolas

    2016-01-01

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  19. Imaging of rectus femoris proximal tendinopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu [Clinique du Sport de Bordeaux, Centre d' Imagerie Osteo-articulaire, Merignac (France); Sonnery-Cottet, Bertrand [Groupe Ramsay Generale de Sante - Hopital Prive Jean Mermoz, Centre Orthopedique Santy, Lyon (France); Graveleau, Nicolas [Clinique du Sport de Bordeaux, Centre de Chirurgie Orthopedique et Sportive, Merignac (France)

    2016-07-15

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  20. Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery.

    Science.gov (United States)

    Trotter, W L; Kaw, P; Meyer, D R; Simon, J W

    2000-08-01

    During the past 2 decades, the introduction of functional endoscopic sinus surgery (FESS) has dramatically improved the treatment of sinus disorders. However, a variety of orbital complications have been reported, including optic nerve damage, hemorrhage, infection, compromise of the lacrimal drainage apparatus, and strabismus. At least 10 cases have reported damage to the medial rectus muscle. (1-8) Treatment options for such patients have been limited, especially because most are adults at risk for anterior segment ischemia after transposition of vertical rectus muscles. We describe 2 patients whose medial rectus myectomies were repaired by using nonabsorbable "hang-back" sutures in combination with a botulinum toxin (Botox) injection of the antagonist lateral rectus muscle. Good primary position alignment was achieved in both patients, and one patient was able to regain binocular function. We recommend this surgical approach, especially in patients at increased risk for anterior segment ischemia.

  1. Effect of tibial bone resection on the development of fast- and slow-twitch skeletal muscles in foetal sheep.

    Science.gov (United States)

    West, J M; Williams, N A; Luff, A R; Walker, D W

    2000-04-01

    To determine if longitudinal bone growth affects the differentiation of fast- and slow-twitch muscles, the tibial bone was sectioned at 90 days gestation in foetal sheep so that the lower leg was permanently without structural support. At 140 days (term is approximately 147 days) the contractile properties of whole muscles, activation profiles of single fibres and ultrastructure of fast- and slow-twitch muscles from the hindlimbs were studied. The contractile and activation profiles of the slow-twitch soleus muscles were significantly affected by tibial bone resection (TIBX). The soleus muscles from the TIBX hindlimbs showed: (1) a decrease in the time to peak of the twitch responses from 106.2 +/- 10.7 ms (control, n = 4) to 65.1 +/- 2.48 ms (TIBX, n = 5); (2) fatigue profiles more characteristic of those observed in the fast-twitch muscles: and (3) Ca2+ - and Sr2+ -activation profiles of skinned fibres similar to those from intact hindlimbs at earlier stages of gestation. In the FDL, TIBX did not significantly change whole muscle twitch contraction time, the fatigue profile or the Ca2+ - and Sr2+ -activation profiles of skinned fibres. Electron microscopy showed an increased deposition of glycogen in both soleus and FDL muscles. This study shows that the development of the slow-twitch phenotype is impeded in the absence of the physical support normally provided by the tibial bone. We suggest that longitudinal stretch is an important factor in allowing full expression of the slow-twitch phenotype.

  2. Topographic Anatomy of the Anal Sphincter Complex and Levator Ani Muscle as It Relates to Intersphincteric Resection for Very Low Rectal Disease.

    Science.gov (United States)

    Tsukada, Yuichiro; Ito, Masaaki; Watanabe, Kentaro; Yamaguchi, Kumiko; Kojima, Motohiro; Hayashi, Ryuichi; Akita, Keiichi; Saito, Norio

    2016-05-01

    Intersphincteric resection has become a widely used treatment for patients with rectal cancer. However, the detailed anatomy of the anal canal related to this procedure has remained unclear. The purpose of this study was to clarify the detailed anatomy of the anal canal. This is a descriptive study. Histologic evaluations of paraffin-embedded tissue specimens were conducted at a tertiary referral hospital. Tissue specimens were obtained from cadavers of 5 adults and from 13 patients who underwent abdominoperineal resection for rectal cancer. Sagittal sections from 9 circumferential portions of the cadaveric anal canal (histologic staining) and 3 circumferential portions from patients were studied (immunohistochemistry for smooth and skeletal muscle fibers). Longitudinal fibers between the internal and external anal sphincters consisted primarily of smooth muscle fibers that continued from the longitudinal muscle of the rectum. The levator ani muscle attached directly to the lateral surface of the longitudinal smooth muscle of the rectum. The length of the attachment was longer in the anterolateral portion and shorter in the posterior portion of the anal canal. In the lateral and posterior portions, the levator ani muscle partially overlapped the external anal sphincter; however, there was less overlap in the anterolateral portion. In the posterior portion, thick smooth muscle was present on the surface of the levator ani muscle and it continued to the longitudinal muscle of the rectum. We observed only limited portions in some surgical specimens because of obstruction by tumors. The levator ani muscle attaches directly to the longitudinal muscle of the rectum. The spatial relationship between the smooth and skeletal muscles differed in different portions of the anal canal. For intersphincteric resection, dissection must be performed between the longitudinal muscle of the rectum and the levator ani muscle/external anal sphincter, and the appropriate surgical lines

  3. Low skeletal muscle mass outperforms the Charlson Comorbidity Index in risk prediction in patients undergoing pancreatic resections.

    Science.gov (United States)

    Wagner, D; Marsoner, K; Tomberger, A; Haybaeck, J; Haas, J; Werkgartner, G; Cerwenka, H; Bacher, H; Mischinger, H J; Kornprat, P

    2018-05-01

    Low skeletal muscle mass is a known predictor of morbidity and mortality in patients undergoing major pancreatic surgeries. We sought to combine low skeletal muscle mass with established risk predictors to improve their prognostic capacity for postoperative outcome and morbidity. As established parameters to predict preoperative mortality risk for patients, the ASA classification and the Charlson Comorbidity Index (CCI) were used. The Hounsfield Units Average Calculation (HUAC) was measured to define low skeletal muscle mass in 424 patients undergoing pancreatic resections for malignancies. Patients in the lowest sex-adjusted quartile for HUAC were defined as having low skeletal muscle mass (muscle wasting). Multivariable Cox regression analysis was utilized to identify preoperative risk factors associated with postoperative morbidity. Median patient age was 63 years (19-87), 47.9% patients were male, and half the cohort had multiple comorbidities (Charlson Comorbidity Index [CCI]>6, 63.2%), 30-day mortality was 5.8% (n = 25). Median HUAC was 19.78 HU (IQR: 15.94-23.54) with 145 patients (34.2%) having low skeletal muscle mass. Preoperative frailty defined by low skeletal muscle mass was associated with an increased risk for postoperative complications (OR 1.55, CI 95% 0.98-2.45, p = 0.014), and a higher 30-day mortality (HR 5.17, CI 95% 1.57-16.69, p = 0.004). With an AUC of 0.85 HUAC showed the highest predictability for 30-day mortality (CI 95% 0.78-0.91, p = 0.0001). Patients with CCI ≥6 and low skeletal muscle mass defined by the HUAC had a 9.78 higher risk of dying in the immediate postoperative phase (HR 9.78, CI 95% 2.98-12.2, p = 0.0001). Low skeletal muscle mass predicts postoperative mortality and complications best and it should be incorporated to conventional risk scores to identify high risk patients. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights

  4. Collagen XII myopathy with rectus femoris atrophy and collagen XII retention in fibroblasts

    DEFF Research Database (Denmark)

    Witting, Nanna; Krag, Thomas; Werlauff, Ulla

    2018-01-01

    INTRODUCTION: Mutation in the collagen XII gene (COL12A1) was recently reported to induce Bethlem myopathy. We describe a family affected by collagen XII-related myopathy in 3 generations. METHODS: Systematic interview, clinical examination, skin biopsies, and MRI of muscle were used. RESULTS...... affection and abnormal collagen XII retention in fibroblasts. MRI disclosed a selective wasting of the rectus femoris muscle. DISCUSSION: COL12A1 mutations should be considered in patients with a mild Bethlem phenotype who present with selective wasting of the rectus femoris, absence of the outside......-in phenomenon on MRI, and abnormal collagen XII retention in fibroblasts. Muscle Nerve, 2018....

  5. Hospitalization for transurethral bladder resection reduces quality of life in Danish patients with non-muscle-invasive bladder tumour

    DEFF Research Database (Denmark)

    Mogensen, Karin; Christensen, Karl B.; Vrang, Marie-Louise

    2016-01-01

    Objective: The aim of the study was to evaluate the impact of transurethral resection of bladder tumour (TURBT) on patients’ quality of life (QoL) and to validate a tool to quantify problems associated with TURBT in a Danish population. Materials and methods: A prospective study was carried out...... using a combination of questionnaires and interviews. The study included 165 consecutive patients undergoing a TURBT owing to non-muscle-invasive bladder cancer (NMIBC) from 1 May 2011 to 30 April 2012. Seven patients were selected for interviews. The Danish translation of the QLQ-NMIBC24 Quality...... of Life Questionnaire for NMIBC, from the European Organisation for Research and Treatment of Cancer (EORTC), was used. The interviews were semi-structured. The reliability of the subscales quantifying QoL as defined by the EORTC was tested by computing Cronbach’s coefficient alpha and confirmatory factor...

  6. Reducing recurrence in non-muscle-invasive bladder cancer using photodynamic diagnosis and immediate post-transurethral resection of the bladder chemoprophylaxis

    DEFF Research Database (Denmark)

    Risager, Malene Bøg; Nielsen, Tommy Kjærgaard; Zieger, Karsten Egbert Arnold

    2015-01-01

    Abstract Objective. The aim of this study was to evaluate the effect of fluorescence cystoscopy and immediate post-transurethral resection of the bladder (TURB) chemoprophylaxis on the risk of recurrence of non-muscle-invasive bladder cancer (NMIBC) under routine clinical conditions. Materials...

  7. Muscle invasive bladder cancer treated by transurethral resection, followed by external beam radiation and interstitial iridium-192

    International Nuclear Information System (INIS)

    Wijnmaalen, Arendjan; Helle, Peter A.; Koper, Peter C.M.; Jansen, Peter P.; Hanssens, Patrick E.J.; Boeken Kruger, Cornelis G.G.; Putten, Wim L.J. van

    1996-01-01

    Purpose: In our center interstitial radiation has played an important role in the treatment of bladder cancer patients for over 40 years. Radium needles, that were initially used, were replaced by caesium needles in 1983, whereas the afterloading iridium wire technique was adopted in 1989. Patients with solitary tumors (T1, T2 and T3) with a surface diameter of < 5 cm are considered for interstitial radiation. In this study we report on the results of the afterloading iridium wire technique in patients with muscle invasive bladder cancer. Materials and Methods: From May 1989 to September 1993 interstitial radiation using iridium wires was part of the treatment in 46 patients with muscle invasive bladder cancer (37 T2, 9 T3). The mean age was 67 years. After transurethral resection of all visible tumor (if possible), in most cases 40 Gy (20 x 2.0 Gy, midplane dose) external beam radiation was delivered to the true pelvis, followed by 30 Gy interstitial radiation using iridium-192 wires covering the tumor area in the bladder. Results: After a median follow-up of 26 months, bladder relapses occurred in 7 patients. In 5 of them the tumor relapsed in the initial area, in 1 patient elsewhere in the bladder and in 1 patient tumor recurred in and outside the initial site. Recurrence was superficial (T1) in 4 patients. A relapse in the urethra was found once. Metastases developed in 13 patients, in 8 without bladder relapse. During the observation period 17 patients died, 13 due to bladder cancer. The actuarial bladder relapse-free survival at 4 years was 74% and 82% for T2 and T3 tumors, respectively. The actuarial distant metastases-free survival was 65% for both categories. No serious toxicity was recorded. Conclusion: In a selected group of patients with muscle invasive bladder cancer transurethral resection in combination with external beam and interstitial radiation provides an excellent opportunity to preserve the bladder with a high chance of success. Development of

  8. Single port-assisted fully laparoscopic abdominoperineal resection (APR) with immediate V-RAM flap reconstruction of the perineal defect.

    LENUS (Irish Health Repository)

    Ali, Sayid

    2012-09-01

    Abdominoperineal resection (APR) of anorectal cancers after neoadjuvant chemoradiotherapy may incur significant perineal morbidity. While vertical rectus abdominis muscle (V-RAM) flaps can fill the pelvic resection space with health tissue, their use has previously been described predominantly in association with laparotomy. Here, we describe a means of combination laparoscopic APR with V-RAM flap reconstruction that allows structural preservation of the entire abdominal wall throughout the oncological resection and of the deep parietal layers after V-RAM donation. Furthermore, a single port access device used at the end colostomy site allows a second senior surgeon assist with an additional two working instruments for the purpose of improved pelvic tissue retraction, especially useful in obese patients.

  9. Rectus sheath haematoma or leaking aortic aneurysm - a diagnostic challenge: a case report

    Directory of Open Access Journals (Sweden)

    Shaw Aidan G

    2009-11-01

    Full Text Available Abstract Introduction A rectus sheath haematoma is a rare condition that arises from the accumulation of blood within the rectus sheath from either muscular tear or rupture of the epigastric vessels. It is a known complication of either blunt abdominal trauma, anticoagulation therapy or the repetitive contraction of the rectus muscle such as paroxysms of coughing. It remains an uncommon and elusive entity and is often clinically misdiagnosed. Case presentation An 80-year-old British man with a known aortic aneurysm was admitted with sudden onset of right iliac fossa pain. The patient was hemodynamically stable and underwent a computed tomography scan which revealed an intact aorta and an acute rectus sheath hematoma. Conclusion To the best of our knowledge, no case has previously been reported involving the diagnostic challenge of a rectus sheath hematoma in a patient with a known aortic aneurysm. Here we discuss the symptoms and signs of a rectus sheath hematoma, as well as the radiological modalities that could be utilized to reach the diagnosis.

  10. Muscle invasive bladder cancer treated by transurethral resection, followed by external beam radiation and interstitial iridium-192

    International Nuclear Information System (INIS)

    Wijnmaalen, Arendjan; Helle, Peter A.; Koper, Peter C.M.; Jansen, Peter P.; Hanssen, Patrick E.; Kruger, Cornelis G.G. Boeken; Putten, Wim L.J. van

    1997-01-01

    Purpose: To evaluate the results of transurethral resection (TUR), external beam radiotherapy (EBRT), and interstitial radiation (IRT) with iridium-192, using the afterloading technique in patients with muscle invasive bladder cancer. Methods and Materials: From May 1989 until September 1995, 66 patients with primary, solitary muscle invasive bladder cancer were treated with TUR, EBRT, and IRT, aiming at bladder preservation. According to the protocol, in three patients low-dose EBRT was applied, whereas 63 patients received high-dose EBRT. Immediately prior to IRT, 42 patients underwent a lymphnode dissection, and in 16 cases a partial cystectomy was performed. For IRT, two to five catheters were used and IRT was started within 24 h after surgery. The majority of patients received 30 Gy of IRT, with a mean dose rate of .58 Gy/h. In three patients, additional EBRT was applied following IRT. Follow-up consisted of regular cystoscopies, mostly done during joint clinics of urologist and radiation oncologist, with urine cytology routinely performed. The median follow-up period was 26 months. The Kaplan-Meier method was used for the determination of survival rates. Results: In seven patients, a bladder relapse developed. The probability of remaining bladder relapse free at 5 years was 88%. The bladder was preserved in 98% of the surviving patients. Metastases developed in 16 patients, and the probability of remaining metastasis free at 5 years was 66%. The cumulative 5-year overall and bladder and distant relapse free survival were 48% and 69%, respectively. Acute toxicity was not serious in the majority of cases; surgical correction of a persisting vesicocutaneous fistula was necessary in two patients, whereas a wound toilet had to be performed in another patient. Serious late toxicity (bladder, RTOG Grade 3) was experienced by only one patient. Conclusions: Interstitial radiation preceded by TUR and EBRT, in a selected group of patients with muscle invasive bladder

  11. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

    Directory of Open Access Journals (Sweden)

    Sung Kyu Bae

    2013-01-01

    Full Text Available BackgroundIf a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect.MethodsFrom 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction.ResultsUpon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery.ConclusionsUsing a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

  12. Thoracic empyema caused by Campylobacter rectus.

    Science.gov (United States)

    Ogata, Tomoyuki; Urata, Teruo; Nemoto, Daisuke; Hitomi, Shigemi

    2017-03-01

    We report a case of thoracic empyema caused by Campylobacter rectus, an organism considered as a periodontal pathogen but rarely recovered from extraoral specimens. The patient fully recovered through drainage of purulent pleural fluid and administration of antibiotics. The present case illustrates that C. rectus can be a cause of not only periodontal disease but also pulmonary infection. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  13. Lateral rectus myositis mimicking an abducens nerve palsy in a pregnant woman.

    Science.gov (United States)

    Haslinda, Abd-Rahim; Shatriah, Ismail; Azhany, Yaakub; Nik-Ahmad-Zuky, Nik-Lah; Yunus, Rohaizan

    2014-01-01

    Myositis is a rare unknown inflammatory disorder of the skeletal muscle tissue. Generalized inflammatory myopathies, polymyositis, and dermatomyositis have been reported during pregnancy. Isolated orbital myositis in pregnancy has not been previously described in the literature. The authors report a case of left isolated orbital myositis in a primigravida at 38 weeks gestation affecting the patient's left lateral rectus muscle. MRI of the orbit was consistent with the diagnosis. She showed remarkable clinical improvement with oral corticosteroids therapy.

  14. Perforator based rectus free tissue transfer for head and neck reconstruction: New reconstructive advantages from an old friend.

    Science.gov (United States)

    Kang, Stephen Y; Spector, Matthew E; Chepeha, Douglas B

    2017-11-01

    To demonstrate three reconstructive advantages of the perforator based rectus free tissue transfer: long pedicle, customizable adipose tissue, and volume reconstruction without muscle atrophy within a contained space. Thirty patients with defects of the head and neck were reconstructed with the perforator based rectus free tissue transfer. Transplant success was 93%. Mean pedicle length was 13.4cm. Eleven patients (37%) had vessel-poor necks and the long pedicle provided by this transplant avoided the need for vein grafts in these patients. Adipose tissue was molded in 17 patients (57%). Twenty-five patients (83%) had defects within a contained space, such as the orbit, where it was critical to have a transplant that avoided muscle atrophy. The perforator based rectus free tissue transfer provides a long pedicle, moldable fat for flap customization, and is useful in reconstruction of defects within a contained space where volume loss due to muscle atrophy is prevented. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Double elevator weakening for unilateral congenital superior oblique palsy with ipsilateral superior rectus contracture and lax superior oblique tendon.

    Science.gov (United States)

    Khan, Arif O

    2012-06-01

    In unilateral congenital superior oblique palsy, a large hypertropia is sometimes associated with ipsilateral contracture of the superior rectus muscle and apparent overaction of the contralateral superior oblique. Ipsilateral double elevator weakening is one surgical approach; however, this procedure could compromise supraduction. We report a series of three consecutive patients who underwent ipsilateral superior rectus and inferior oblique recessions for unilateral superior oblique palsy. Intraoperatively, all three patients were found to have a lax ipsilateral superior oblique tendon. Postoperatively, all three patients had satisfactory correction of the hypertropia and abnormal head position with minimal supraduction defect. This procedure seems to be an acceptable initial surgical option for treating congenital superior oblique muscle palsy with ipsilateral contracture of the superior rectus muscle, even when the ipsilateral superior oblique tendon is lax. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  16. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

    Directory of Open Access Journals (Sweden)

    Sung Kyu Bae

    2013-01-01

    Full Text Available Background If a chronically infected abdominal wound develops, complications such asperitonitis and an abdominal wall defect could occur. This could prolong the patient’s hospitalstay and increase the possibility of re-operation or another infection as well. For this reason,a solution for infection control is necessary. In this study, surgery using a rectus abdominismuscle myofascial splitting flap was performed on an abdominal wall defect.Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture,cesarean section, or uterine myoma were chosen. In each case, during the first week afteroperation, the wound showed signs of infection. Surgery was chosen because the wounds didnot resolve with dressing. Debridement was performed along the previous operation woundand dissection of the skin was performed to separate the skin and subcutaneous tissue fromthe attenuated rectus muscle and Scarpa’s fascial layers. Once the anterior rectus sheath andmuscle were adequately mobilized, the fascia and muscle flap were advanced medially sothat the skin defect could be covered for reconstruction.Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation,no major complication occurred. In addition, all of the patients showed satisfaction in termsof function and esthetics at 3 to 6 months post-surgery.Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic andfunctional benefits over previous methods of abdominal defect treatment, and notably, itenabled infection control by reconstruction using muscle.

  17. Lower abdominal wall reconstructions with pedicled rectus femoris flaps

    International Nuclear Information System (INIS)

    Arashiro, Ken; Nishizeki, Osamu; Ishida, Kunihiro

    2003-01-01

    During the past 10 years, seven pedicled rectus femoris muscle or musculocutaneous flaps were used to repair lower abdominal defects; three recalcitrant incisional hernias with previous radiotherapy, two long-standing wound infections after synthetic mesh reconstruction, one posttraumatic wall defect and one metastatic tumor. There were two flap complications, one skin paddle necrosis and one wound infection. There was no significant disability of the donor limb encountered. During the two-year and seven month average follow-up, there was no recurrence of the problems except for one minor fascial dehiscence in the patient with metastatic abdominal wall tumor. Easy approach, rapid harvest, relatively large and reliable overlying fascia lata, a single dominant neurovascular pedicle, easy primary closure of the donor site, and minimal donor site morbidity all make the rectus femoris flap a good alternative flap for lower abdominal wall reconstruction. It is especially useful in a condition where synthetic mesh would be unsuitable for defects with infection or recurrent incisional hernia after radiotherapy. (author)

  18. Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer

    NARCIS (Netherlands)

    Boer, B. C.; de Graaff, F.; Brusse-Keizer, M.; Bouman, D. E.; Slump, C. H.; Slee-Valentijn, M.; Klaase, J. M.

    The prevalence of colorectal cancer in the elderly is increasing and, therefore, surgical interventions with a risk of potential complications are more frequently performed. This study investigated the role of low skeletal muscle mass (sarcopenia), muscle quality, and the sarcopenic obesity as

  19. Loop myopexy with true muscle transplantation for very large angle heavy eye syndrome patient

    Directory of Open Access Journals (Sweden)

    Jitendra Jethani

    2015-01-01

    Full Text Available A 42-year-old man presenting with complaints of squint for last 20 years. His visual acuity was 20/400 in right eye (RE and 20/30 in left eye (LE with glasses. His refraction was RE -16.75/-2.5 D cycl 180 and LE was -14.5/-1.5 D cycl 180. His axial length was 31.23 mm In RE and 29.72 mm in LE. On examination we found he had RE large esotropia with hypotropia measuring 130 pd base out and 40 pd base up in RE. A computerized tomography scan revealed that the superior rectus (SR was shifted nasally, and lateral rectus (LR was shifted inferiorly. A RE medial rectus (MR recession and LR resection with muscle transplantation on the MR was done. A loop myopexy was done to correct the path of the LR and SR. The patient had only 18 pd eso and 20 pd hypo on follow-up after 3 months. Loop myopexy in conjunction with muscle transplantation is a safe and effective procedure for large angle esotropia associated with heavy eye syndrome.

  20. Improvements in Vertebral-Column Angles and Psychological Metrics After Abdominoplasty With Rectus Plication.

    Science.gov (United States)

    Temel, Metin; Türkmen, Arif; Berberoğlu, Ömer

    2016-05-01

    Substantial fluctuations in body weight can result in diastasis recti and weakening of the connections between the lateral abdominal muscles and the rectus sheath. The authors sought to determine the postural and psychological effects of abdominoplasty with vertical rectus plication. Forty women with substantial back and lumbar pain owing to abdominal lipodystrophy were evaluated in a prospective study. Preoperatively and 6 months postoperatively, patients underwent bidirectional radiography of the thoracic and lumbar regions. A visual analog scale (VAS), the Beck Depression Inventory (BDI), and the Nottingham Health Profile (NHP) were applied to assess physical, psychological, and quality-of-life changes following surgery. Significant improvements in posture, assessed in terms of lumbar lordosis, thoracic kyphosis, and the lumbosacral angle, were observed 6 months after abdominoplasty with rectus plication. Results of the VAS and BDI indicated significant improvements in pain and quality of life, respectively. Results of the NHP indicated significant postoperative improvements in fatigue, pain, and sleep. Abdominoplasty with rectus plication improves posture by tightening the thoracolumbar fascia. In selected patients, abdominoplasty can reduce back and lumbar pain, thereby improving quality of life. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  1. Surgical treatment of benign tracheo-oesophageal fistulas with tracheal resection and oesophageal primary closure: is the muscle flap really necessary?

    Science.gov (United States)

    Camargo, José Jesus; Machuca, Tiago Noguchi; Camargo, Spencer Marcantônio; Lobato, Vivalde F; Medina, Carlos Remolina

    2010-03-01

    Nowadays, despite the advances of the low-pressure high-volume cuffs, post-intubation tracheo-oesophageal fistula (TEF) still poses a major challenge to thoracic surgeons. The original technique includes interposition of muscle flaps between suture lines to avoid recurrence. It is not clear if this manoeuvre is indispensable and, in fact, we and others have faced problems with it. Our aim is to present our experience with TEF management in a consecutive group with no muscle interposition. From June 1992 to November 2007, we evaluated 14 patients presenting with TEF, with a mean age of 44 years (from 18 to 79 years). Thirteen patients had a prolonged intubation history. The remaining case was a 40-year-old male with congenital TEF. Three patients had been previously submitted to failed repairs in other institutions. Ten patients had associated tracheal stenosis, which was subglottic in three of them. Regarding surgical technique, in all cases, we performed a single-staged procedure, which consisted of tracheal resection and anastomosis with double-layer oesophageal closure. In none of our cases was a muscle flap interposed between suture lines. All operations were performed through a cervical incision; however, in one case, an extension with partial sternotomy was required. There was no operative mortality. Thirteen patients were extubated in the first 24h after the procedure, while one patient required 48 h of mechanical ventilation. Four complications were recorded: one each of pneumonia and left vocal cord paralysis and two small tracheal dehiscences managed with a T-tube and a tracheostomy tube. After discharge, three patients returned to their native cities and were lost to follow-up. The remaining 11 patients have been followed up by a mean of 32 months (from three to 108 months), with 10 presenting excellent and one good anatomic and functional results. The single-staged repair with tracheal resection and anastomosis with oesophageal closure provides good

  2. the sternalis muscle

    African Journals Online (AJOL)

    2009-08-17

    Aug 17, 2009 ... CASE REPORT. CASE. 72. SA JOURNAL OF RADIOLOGY • August 2009. CASE R. Introduction ... tion is being given to imaging the medial breast, and the sternalis muscle will be revealed with increasing ... The origin of this muscle is uncertain, with pectoralis major, rectus abdominus and sternomastoid ...

  3. Factors affecting residual exotropia after two muscle surgery for intermittent exotropia

    Directory of Open Access Journals (Sweden)

    Shailja Tibrewal

    2017-07-01

    Full Text Available AIM: To study the factors affecting residual exotropia (>10 PD at 4-6wk postoperative visit following two rectus muscle surgery for intermittent exotropia [bilateral lateral rectus (LR recession or unilateral recess resect procedure]. METHODS: A retrospective chart review of patients with intermittent exotropia ≤50 PD who underwent two rectus muscle surgery in between Jan. 2011 to Dec. 2013 was performed. Possible factors were compared between patients with residual exotropia (>10 PD and successful outcome (within 10 PD of orthotropia at the 4-6wk postoperative visit. Effect/dose ratio was calculated by dividing the effect of surgery by the total amount (mm of muscle surgery done. RESULTS: One hundred and fifty-seven patients with mean age of 14y (range 3-53y were included. Twenty-seven patients (17.2% had residual exotropia at 4-6wk postoperative follow up. Age at surgery (P=0.009 and preoperative deviation for distance (P≤0.001 and near (P=0.001 were identified as important predictors of unsuccessful outcome. The occurrence of residual exotropia was not affected by amblyopia, anisometropia, lateral incomitance, pattern deviation, vertical deviation, type of exotropia or type of surgery done (recess-resect or bilateral LR recession. The effect/dose ratio was more in deviations >40 PD in the both recess-resect and bilateral LR recession type of surgery. The effect/dose ratio was less in patients with residual exotropia as compared to the successful outcome group (1.36 PD/mm vs 2.05 PD/mm in the bilateral LR recession surgery and 1.93 PD/mm vs 2.63 PD/mm in the unilateral recess-resect surgery. CONCLUSION: Residual exotropia is seen in 17% of patients after two muscle surgery for intermittent exotropia. Patients with older age and larger preoperative deviation have greater chances of developing failure of two muscle strabismus surgery for intermittent exotropia.

  4. Effect of 4-Horizontal Rectus Muscle Tenotomy on Visual Function and Eye Movement Records in Patients with Infantile Nystagmus Syndrome without Abnormal Head Posture and Strabismus: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Ahmad Ameri

    2013-10-01

    Full Text Available Purpose: To evaluate the effect of tenotomy on visual function and eye movement records in patients with infantile nystagmus syndrome (INS without abnormal head posture (AHP and strabismusMethods: A prospective interventional case-series of patients with INS with no AHP or strabismus. Patients underwent 4-horizontal muscle tenotomy. Best corrected visual acuity (BCVA and eye movement recordings were compared pre and postoperatively.Results: Eight patients were recruited in this study with 3 to 15.5 months of follow-up. Patients showed significant improvement in their visual function. Overall nystagmus amplitude and velocity was decreased 30.7% and 19.8%, respectively. Improvements were more marked at right and left gazes. Conclusion: Tenotomy improves both visual function and eye movement records in INS with no strabismus and eccentric null point. The procedure has more effect on lateral gazes with worse waveforms, thus can broaden area with better visual function. We recommend this surgery in patients with INS but no associated AHP or strabismus.

  5. A network meta-analysis of therapeutic outcomes after new image technology-assisted transurethral resection for non-muscle invasive bladder cancer: 5-aminolaevulinic acid fluorescence vs hexylaminolevulinate fluorescence vs narrow band imaging

    International Nuclear Information System (INIS)

    Lee, Joo Yong; Cho, Kang Su; Kang, Dong Hyuk; Jung, Hae Do; Kwon, Jong Kyou; Oh, Cheol Kyu; Ham, Won Sik; Choi, Young Deuk

    2015-01-01

    This study included a network meta-analysis of evidence from randomized controlled trials (RCTs) to assess the therapeutic outcome of transurethral resection (TUR) in patients with non-muscle-invasive bladder cancer assisted by photodynamic diagnosis (PDD) employing 5-aminolaevulinic acid (5-ALA) or hexylaminolevulinate (HAL) or by narrow band imaging (NBI). Relevant RCTs were identified from electronic databases. The proceedings of relevant congresses were also searched. Fifteen articles based on RCTs were included in the analysis, and the comparisons were made by qualitative and quantitative syntheses using pairwise and network meta-analyses. Seven of 15 RCTs were at moderate risk of bias for all quality criteria and two studies were classified as having a high risk of bias. The recurrence rate of cancers resected with 5-ALA-based PDD was lower than of those resected using HAL-based PDD (odds ratio (OR) = 0.48, 95 % confidence interval (CI) [0.26–0.95]) but was not significantly different than those resected with NBI (OR = 0.53, 95 % CI [0.26–1.09]). The recurrence rate of cancers resected using HAL-based PDD versus NBI did not significantly differ (OR = 1.11, 95 % CI [0.55–2.1]). All cancers resected using 5-ALA-based PDD, HAL-based PDD, or NBI recurred at a lower rate than those resected using white light cystoscopy (WLC). No difference in progression rate was observed between cancers resected by all methods investigated. The recurrence rate of some bladder cancers can be decreased by the implementation of either PDD- and NBI-assisted TUR; in real settings, clinicians should consider replacing WLC as the standard imaging technology to guide TUR

  6. Use of the Anterolateral Thigh and Vertical Rectus Abdominis Musculocutaneous Flaps as Utility Flaps in Reconstructing Large Groin Defects

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    Edwin Jonathan Aslim

    2014-09-01

    Full Text Available BackgroundGroin dissections result in large wounds with exposed femoral vessels requiring soft tissue coverage, and the reconstructive options are diverse. In this study we reviewed our experience with the use of the pedicled anterolateral thigh and vertical rectus abdominis musculocutaneous flaps in the reconstruction of large groin wounds.MethodsGroin reconstructions performed over a period of 10 years were evaluated, with a mean follow up of two years. We included all cases with large or complex (involving perineum defects, which were reconstructed with the pedicled anterolateral thigh musculocutaneous or the vertical rectus abdominis musculocutaneous (VRAM flaps. Smaller wounds which were covered with skin grafts, locally based flaps and pedicled muscle flaps were excluded.ResultsTwenty-three reconstructions were performed for large or complex groin defects, utilising the anterolateral thigh (n=10 and the vertical rectus abdominis (n=13 pedicled musculocutaneous flaps. Femoral vein reconstruction with a prosthetic graft was required in one patient, and a combination flap (VRAM and gracilis muscle flap was performed in another. Satisfactory coverage was achieved in all cases without major complications. No free flaps were used in our series.ConclusionsThe anterolateral thigh and vertical rectus abdominis pedicled musculocutaneous flaps yielded consistent results with little morbidity in the reconstruction of large and complex groin defects. A combination of flaps can be used in cases requiring extensive cover.

  7. Traumatic 6th Nerve Palsy Managed with Medial Rectus Recession ...

    African Journals Online (AJOL)

    in left eye in primary gaze [Figure 1]. All movements of left eye were restricted in all directions of gaze except ... improvement of abduction, and larger field of binocular ... and inferior rectus lateral 2/3 near lateral rectus tendon insertion.

  8. Morphometry of extraocular muscles in Basedow disease by computed tomography

    International Nuclear Information System (INIS)

    Miura, Michiko; Ohtsuka, Kenji; Hashimoto, Masato

    1996-01-01

    We measured the thickness of extraocular muscles in 35 patients diagnosed as Basedow disease by physicians. We used the coronal images of computed tomography in measuring the thickness at four points for each muscle. The mean thickness was 3.2±1.0 mm for superior rectus, 3.4±0.8 mm for medial rectus and 4.1 mm±13 mm for inferior rectus. These values were significantly larger than in normal eyes (p<0.01). The value for inferior rectus was significantly larger than for the other two muscles (p<0.01). Thickness of inferior rectus at its posterior portion was significantly correlated with limitation of supraduction of the affected eye (r=0.7). (author)

  9. Dynamic Rectus Abdominis Muscle Sphincter for Stomal Continence

    NARCIS (Netherlands)

    Bardoel, J.W.J.M. (Janou)

    2002-01-01

    Some life-saving surgeries result in the necessity to establish permanent intestinal stomas; this outcome has an undeniable physical and emotional effect on the patient's life. Although patients with permanent stomas reasonably adjust, complications that include peristomal skin irritation, pouching

  10. Free tissue transfer of the rectus abdominis myoperitoneal flap for oral reconstruction in a dog.

    Science.gov (United States)

    Lanz, O I

    2001-12-01

    A five-month-old intact/male Boxer dog was presented 5-days following bite wound trauma to the maxillary region resulting in an oronasal fistula extending from the maxillary canine teeth to the soft palate. Multiple surgical procedures using local, buccal mucosal flaps failed to repair the oronasal fistula. Free tissue transfer of the rectus abdominis myoperitoneal flap using microvascular surgical techniques was successful in providing soft tissue reconstruction of the hard palate area. Complications of these surgical techniques included muscle contraction and subsequent muzzle distortion. Small, refractory oronasal fistulae at the perimeter of the myoperitoneal flap were repaired by primary wound closure.

  11. Isolated Medial Rectus Nuclear Palsy as a Rare Presentation of Midbrain Infarction.

    Science.gov (United States)

    Al-Sofiani, Mohammed; Lee Kwen, Peterkin

    2015-10-08

    Diplopia is a common subjective complaint that can be the first manifestation of a serious pathology. Here, we report a rare case of midbrain infarction involving the lateral subnucleus of the oculomotor nuclear complex presenting as diplopia, with no other stroke manifestations. An 83-year-old right-handed white man with past medical history of diabetes mellitus, hypertension, dyslipidemia, and coronary artery disease presented to the emergency department (ED) with diplopia and unsteadiness. Two days prior to admission, the patient woke up with constant horizontal diplopia and unsteadiness, which limited his daily activities and led to a fall at home. He denied any weakness, clumsiness, nausea, vomiting, photophobia, fever, or chills. Ocular exam showed a disconjugate gaze at rest, weakness of the left medial rectus muscle, impaired convergence test, and bilateral 3-mm reactive pupils. The diplopia resolved by closing either eye. The remaining extraocular muscles and other cranial nerves were normal. There was no nystagmus, ptosis, or visual field deficit. Sensation, muscle tone, and strength were normal in all extremities. Magnetic resonance imaging (MRI) of the brain revealed a tiny focus of restricted diffusion in the left posterior lateral midbrain. A thorough history and physical examination is essential to diagnose and manage diplopia. Isolated extraocular palsy is usually thought to be caused by orbital lesions or muscular diseases. Here, we report a case of midbrain infarction manifested as isolated medial rectus palsy.

  12. A comparative study of different amniotic membrane orientations during extraocular muscle surgery in rabbits.

    Science.gov (United States)

    Kassem, Rehab Rashad; El-Mofty, Randa Mohamed Abdel-Moneim; Khodeir, Mustafa Mahmoud; Hamza, Wael Mostafa

    2018-03-01

    To histopathologically compare the effect of different orientations of cryopreserved human amniotic membrane (AM) transplant during extraocular muscle surgery in rabbits. Fifty-two albino rabbit eyes underwent 4-mm resection of the superior rectus. Eyes were randomly divided into four groups. In Group C (Control group, 16 eyes) the muscle was not wrapped with amniotic membrane. In the three AM groups, cryopreserved AM was wrapped around the muscle, oriented with either its stroma (Group S, 15 eyes) or epithelium (Group E, nine eyes) towards the muscle, or folded on itself with the epithelium externally (Group F, 12 eyes). The rabbits were sacrificed and the eyes were enucleated 6 weeks after surgery. Histopathological examination was conducted for periamniotic, foreign body, scleral, and conjunctival inflammation, conjunctival vascularity, adhesions and muscle fibrosis. In all AM eyes, the AM was surrounded by periamniotic inflammation, with no adhesions detected between the muscle and surrounding tissues in the segment where the AM was present, but detected elsewhere. Adhesions were detected in all group C eyes. Foreign body inflammation was significantly less in Group C than in each of the AM groups (p  .05). Scleral inflammation was absent in all specimens. No significant differences were noted among all groups in terms of conjunctival vascularity, conjunctival inflammation, or muscle fibrosis (p > .05). All AM orientations were equally effective in preventing the development of postoperative adhesions between the extraocular muscle and surrounding tissues.

  13. Evaluation of Accessory Lacrimal Gland in Muller's Muscle Conjunctival Resection Specimens for Precursor Cell Markers and Biological Markers of Dry Eye Disease.

    Science.gov (United States)

    Ali, Marwan; Shah, Dhara; Pasha, Zeeshan; Jassim, Sarmad H; Jassim Jaboori, Assraa; Setabutr, Pete; Aakalu, Vinay K

    2017-04-01

    The accessory lacrimal glands (ALGs) are an understudied component of the tear functional unit, even though they are important in the development of dry eye syndrome (DES). To advance our understanding of aging changes, regenerative potential, and histologic correlates to human characteristics, we investigated human ALG tissue from surgical samples to determine the presence or absence of progenitor cell markers and lacrimal epithelial markers and to correlate marker expression to relevant patient characteristics. ALG tissues obtained from Muller's muscle conjunctival resection (MMCR) specimens were created using tissue microarrays (TMAs). Immunofluorescence staining of MMCR sections was performed using primary antibodies specific to cell protein markers. Cell marker localization in TMAs was then assessed by two blinded observers using a standardized scoring system. Patient characteristics including age, race, and status of ocular surface health were then compared against expression of stem cell markers. Human ALG expressed a number of epithelial markers, and in particular, histatin-1 was well correlated with the expression of epithelial markers and was present in most acini. In addition, we noted the presence of precursor cell markers nestin, ABCG2, and CD90 in ALG tissue. There was a decrease in precursor cell marker expression with increasing age. Finally, we noted that a negative association was present between histatin-1 expression and DES. Thus, we report for the first time that human ALG tissues contain precursor marker-positive cells and that this marker expression may decrease with increasing age. Moreover, histatin-1 expression may be decreased in DES. Future studies will be performed to use these cell markers to isolate and culture lacrimal epithelial cells from heterogeneous tissues, determine the relevance of histatin-1 expression to DES, and isolate candidate precursor cells from ALG tissue.

  14. Evaluation of Accessory Lacrimal Gland in Muller’s Muscle Conjunctival Resection Specimens for Precursor Cell Markers and Biological Markers of Dry Eye Disease

    Science.gov (United States)

    Ali, Marwan; Shah, Dhara; Pasha, Zeeshan; Jassim, Sarmad H.; Jaboori, Assraa Jassim; Setabutr, Pete; Aakalu, Vinay K.

    2017-01-01

    Purpose The accessory lacrimal glands (ALG) are an understudied component of the tear functional unit, even though they are important in the development of dry eye syndrome (DES). To advance our understanding of aging changes, regenerative potential and histologic correlates to human characteristics, we investigated human ALG tissue from surgical samples to determine the presence or absence of progenitor cell markers and lacrimal epithelial markers and to correlate marker expression to relevant patient characteristics. Materials and Methods ALG tissues obtained from Muller’s Muscle Conjunctival Resection (MMCR) specimens were created using tissue microarrays (TMAs). Immunofluorescence staining of MMCR sections was performed using primary antibodies specific to cell protein markers. Cell marker localization in TMAs was then assessed by two blinded observers using a standardized scoring system. Patient characteristics including age, race, and status of ocular surface health were then compared against expression of stem cell markers. Results Human ALG expressed a number of epithelial markers, and in particular, histatin-1 was well correlated with the expression of epithelial markers and was present in most acini. In addition, we noted the presence of precursor cell markers nestin, ABCG2 and CD90 in ALG tissue. There was a decrease in precursor cell marker expression with increasing age. Finally, we noted that a negative association was present between histatin-1 expression and DES. Conclusions Thus, we report for the first time that human ALG tissues contain precursor marker positive cells and that this marker expression may decrease with increasing age. Moreover, histatin-1 expression may be decreased in DES. Future studies will be performed to use these cell markers to isolate and culture lacrimal epithelial cells from heterogeneous tissues, determine the relevance of histatin-1 expression to DES and isolate candidate precursor cells from ALG tissue. PMID:27612554

  15. Herniated gyrus rectus causing idiopathic compression of the optic chiasm.

    Science.gov (United States)

    Smith, Jacob; Jack, Megan M; Peterson, Jeremy C; Chamoun, Roukoz B

    2017-02-01

    Anomalies in the frontal lobe can interfere with visual function by compression of the optic chiasm and nerve. The gyrus rectus is located at the anterior cranial fossa floor superior to the intracranial optic nerves and chiasm. Compression of these structures by the gyrus rectus is often caused by neoplastic or dysplastic growth in the area. We report a rare case of a herniated gyrus rectus impinged on the optic chiasm and nerve without a clear pathological cause for the herniation. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Análise histológica e histoquímica das fibras dos músculos reto do abdome e intercostal paraesternal de ratos submetidos ao exercício da natação Histologic and histochemical analysis of fibers of rectus of abdomen and paraesternal intercostal muscles of Wistar rats after swimming exercise

    Directory of Open Access Journals (Sweden)

    Paulo César Bálade Saad

    2002-08-01

    ção aeróbica, com conseqüente aumento do percentual de fibras oxidativas, induzindo maior resistência à fadiga.The objective of the present study was to evaluate the influence of swimming exercise on metabolic and contractile abilities of rectus of abdomen and the paraesternal intercostal muscle fibers. Adult Wistar rats were initially submitted to an adaptation period and then divided into control and exercise groups. Exercised animals were submitted to swimming for 15, 30, 45, and 60 days, 1 hr/day, 5days/week. At the end of each period, the animals were killed. Small segments of the above muscles were frozen in N-hexane at -70ºC, pre-cooled with liquid nitrogen for two minutes. Histological transverse sections (7 µm were obtained in a cryostat microtome at -20ºC. Some serial sections were stained with HE. Subsequent sections were reacted for NADH-TR to evaluate the oxidizing capacity, and for m-ATPase, after acid and alkaline pre-incubations mediums. Under microscopic examination, the frequencies of fiber types were sampled. Muscle fibers revealed to be grouped in different fascicles, presenting polygonal outlines, with different diameters. Three kind of fibers were detected: SO (slow oxidative, FOG (fast oxidative glycolytic and FG (fast glycolytic, presenting a mosaic pattern distribution. The analysis of the results demonstrated that after 60 days of exercise, the abdominal muscles showed a significant increase in the frequency of SO fibers. After 15 days, a significant decrease in frequency of intermediate FOG fibers and an increase of FG fibers. The paraesternal intercostal muscles revealed a significant increase in the percentage of SO fibers in the 60 day-exercised animals, a percentage increase of FOG fibers in the animals of 45 and 60 days, and a percentage decrease of FG fibers in those of 30, 45 and 60 days. So, due to hydrostatic pressure in swimming exercise, the degree of work was greater in the inspiration muscles. This increase was parallel with

  17. Effects of Acupuncture Therapy on the EMG Activity of the Rectus Femoris and Tibialis Anterior during Maximal Voluntary Isometric Contraction in College Students

    Directory of Open Access Journals (Sweden)

    Se In Jang

    2017-12-01

    Full Text Available Acupuncture has been increasingly used in the treatment of muscle damage associated with sports activities. However, studies on the immediate effects of one-time acupuncture on the muscles of athletes are clearly lacking. Thus, this study aimed to examine the effects of acupuncture therapy on the maximal voluntary isometric contraction (MVIC electromyography (EMG of the rectus femoris and tibialis anterior muscles. This study was conducted among 20 healthy male college students who had no musculoskeletal disease. The participants were subjected to 3 different experimental conditions and subsequently grouped based on these conditions: real acupuncture, sham acupuncture, and control. A 7-day washout period was implemented to avoid any transient effects on the physiological and psychological conditions of the participants. Subsequently, an electromyogram patch was attached on the most developed area in the middle of the origin and insertion of the rectus femoris and tibialis anterior muscles. The percent MVIC, which was used to standardize the signal from the electromyogram, was determined, and the maximal value from the MVIC of the rectus femoris and tibialis anterior muscles was measured. The MVIC EMG activities of both femoris (F = 6.633, p = 0.003 and tibialis anterior (F = 5.216, p = 0.008 muscles were significantly different among all groups. Accordingly, the results of a posthoc test showed that the real acupuncture group had higher MVIC EMG activities in the femoris (p = 0.002 and tibialis anterior (p = 0.006 muscles compared with the control group. These results suggest that treatment with real acupuncture resulted in significantly higher MVIC EMG activities of the rectus femoris and tibialis anterior muscles than the other treatments. Hence, acupuncture may be helpful in the improvement of muscle strength among athletes in the physical fitness field.

  18. Surgical treatment of rectus femoris injury in soccer playing athletes: report of two cases.

    Science.gov (United States)

    Shimba, Leandro Girardi; Latorre, Gabriel Carmona; Pochini, Alberto de Castro; Astur, Diego Costa; Andreoli, Carlos Vicente

    2017-01-01

    Muscle injury is the most common injury during sport practice. It represents 31% of all lesions in soccer, 16% in track and field, 10.4% in rugby, 17.7% in basketball, and between 22% and 46% in American football. The cicatrization with the formation of fibrotic tissue can compromise the muscle function, resulting in a challenging problem for orthopedics. Although conservative treatment presents adequate functional results in the majority of the athletes who have muscle injury, the consequences of treatment failure can be dramatic, possibly compromising the return to sport practice. The biarticular muscles with prevalence of type II muscle fibers, which are submitted to excentric contraction, present higher lesion risk. The quadriceps femoris is one example. The femoris rectus is the quadriceps femoris muscle most frequently involved in stretching injuries. The rupture occurs in the acceleration phase of running, jump, ball kicking, or in contraction against resistance. Although the conservative treatment shows good results, it is common that the patient has lower muscle strength, difficulty in return to sports, and a permanent and visible gap. Surgical treatment can be an option for a more efficient return to sports.

  19. Surgical treatment of rectus femoris injury in soccer playing athletes: report of two cases

    Directory of Open Access Journals (Sweden)

    Leandro Girardi Shimba

    Full Text Available ABSTRACT Muscle injury is the most common injury during sport practice. It represents 31% of all lesions in soccer, 16% in track and field, 10.4% in rugby, 17.7% in basketball, and between 22% and 46% in American football. The cicatrization with the formation of fibrotic tissue can compromise the muscle function, resulting in a challenging problem for orthopedics. Although conservative treatment presents adequate functional results in the majority of the athletes who have muscle injury, the consequences of treatment failure can be dramatic, possibly compromising the return to sport practice. The biarticular muscles with prevalence of type II muscle fibers, which are submitted to excentric contraction, present higher lesion risk. The quadriceps femoris is one example. The femoris rectus is the quadriceps femoris muscle most frequently involved in stretching injuries. The rupture occurs in the acceleration phase of running, jump, ball kicking, or in contraction against resistance. Although the conservative treatment shows good results, it is common that the patient has lower muscle strength, difficulty in return to sports, and a permanent and visible gap. Surgical treatment can be an option for a more efficient return to sports.

  20. Applied force and elongation in the medial rectus in esotropic patients with and without movement restriction.

    Science.gov (United States)

    Krieger, Fernanda; Cvintal, Tadeu; Bicas, Harley

    2004-12-01

    To study the different ways of expressing the force-elongation relationship in medial rectus muscles in esotropia with and without muscular restriction. Twenty-nine passive force-elongation curves were obtained without restriction (group I, n = 13) and with restriction (group II, n = 10) by means of a manual pachymeter and a digital dynamometer. In group I, the mean age was 14 years and 7 days and the mean esotropia was 53.88(Delta) while in group II the mean age was 35 years and 5 days and the mean esotropia was 60.5(Delta). Comparisons of structural muscular parameters between groups I and II were made for length (38.69 +/- 0.75 vs. 32.48 +/- 1.84 mm, p elongation relationship, whether normalized or not, followed an exponential curve. The constant c, which represents force when the elongation is zero, remained the same in all curves. In contrast, the constant b, which represents the slope of the curve, showed a significant difference between the two groups only for the curves of force-absolute elongation and tension-absolute elongation. The results imply that the constant b is better for characterizing the difference between the behavior of the medial rectus in esotropia with and without restriction. In addition, the elongation normalization showed that the contractile component is similar between the two groups and, therefore, the classical way of analysis, which does not employ normalization, is appropriate to correlate muscle properties with clinical findings.

  1. Ocular-muscle surgery for filamentary keratitis that developed in double elevator palsy.

    Science.gov (United States)

    Hieda, Osamu; Yokoi, Norihiko; Sotozono, Chie

    2017-01-01

    To report a case of filamentary keratitis occurring in the cornea hidden under the eyelids by squint surgery. A 69-year-old female patient with a history of amblyopia was referred for intractable filamentary keratitis in the left eye. The strabismus angle was 35Δ hypertrophic, and ocular motility was within the normal range. Slit-lamp examination of her left eye revealed filamentary keratitis in more than one-third of the upper cornea behind the upper eyelid. Her right eye was diagnosed as supranuclear double elevator palsy. We performed strabismus surgery on her right eye, including inferior rectus muscle recession (5 mm) in combination with superior rectus muscle resection (5 mm) under local anesthesia. Following surgery, the left eye squint angle was improved. The filamentary keratitis of the left eye disappeared, and there was no recurrence over the following 5 years. The squint surgery of paralyzed right eye decreased the strabismus angle, subsequently resulting in the disappearance of the filamentary keratitis in the left eye via the resolution of the relative blepharoptosis. Although the squint operation performed was not for the purpose of improving binocular function, we want to conclude that it can treat the filamentary keratitis behind the eyelid.

  2. Ocular-muscle surgery for filamentary keratitis that developed in double elevator palsy

    Directory of Open Access Journals (Sweden)

    Hieda O

    2017-12-01

    Full Text Available Osamu Hieda, Norihiko Yokoi, Chie Sotozono Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Purpose: To report a case of filamentary keratitis occurring in the cornea hidden under the eyelids by squint surgery.Methods: A 69-year-old female patient with a history of amblyopia was referred for intractable filamentary keratitis in the left eye. The strabismus angle was 35Δ hypertrophic, and ocular motility was within the normal range. Slit-lamp examination of her left eye revealed filamentary keratitis in more than one-third of the upper cornea behind the upper eyelid. Her right eye was diagnosed as supranuclear double elevator palsy. We performed strabismus surgery on her right eye, including inferior rectus muscle recession (5 mm in combination with superior rectus muscle resection (5 mm under local anesthesia. Following surgery, the left eye squint angle was improved. The filamentary keratitis of the left eye disappeared, and there was no recurrence over the following 5 years.Conclusion: The squint surgery of paralyzed right eye decreased the strabismus angle, subsequently resulting in the disappearance of the filamentary keratitis in the left eye via the resolution of the relative blepharoptosis. Although the squint operation performed was not for the purpose of improving binocular function, we want to conclude that it can treat the filamentary keratitis behind the eyelid. Keywords: filamentary keratitis, squint surgery, double elevator palsy, amblyopia

  3. Extensive actinomycosis of the face requiring radical resection and facial nerve reconstruction.

    Science.gov (United States)

    Iida, Takuya; Takushima, Akihiko; Asato, Hirotaka; Harii, Kiyonori

    2006-01-01

    We present a case of extensive actinomycosis of the face, which appeared after dental surgery. Since antibiotic therapy was ineffective, the lesion was radically resected, and the skin, soft tissue and facial nerve were reconstructed using a free rectus abdominis musculocutaneous flap and simultaneously harvested intercostal nerves. Successful reanimation of the face was achieved 14 months postoperatively.

  4. Campylobacter gracilis and Campylobacter rectus in primary endodontic infections.

    Science.gov (United States)

    Siqueira, J F; Rôças, I N

    2003-03-01

    A species-specific nested polymerase chain reaction (PCR) assay was used to investigate the occurrence of Campylobacter gracilis and C. rectus in primary root canal infections. Samples were collected from 57 single-rooted teeth with carious lesions, necrotic pulps and radiographic evidence of periradicular disease. Twenty-eight cases were diagnosed as chronic asymptomatic periradicular lesions, 12 cases as acute apical periodontitis, and 17 cases as acute periradicular abscess. DNA was extracted from the samples and initially amplified using universal 16S rDNA primers. A second round of amplification using the first PCR products was performed to specifically detect C. gracilis or C. rectus in the samples. Campylobacter gracilis and C. rectus were, respectively, detected in 21.4 (6 of 28) and 30% (6 of 20) of the root canals associated with chronic asymptomatic periradicular lesions. Campylobacter gracilis was found in 16.7% (2 of 12) of the cases diagnosed as acute apical periodontitis, whilst C. rectus was found in 33.3% (two of six cases). In the abscessed cases, C. gracilis and C. rectus were detected in 23.5 (4 of 17) and 11.8% (2 of 17) of the cases, respectively. No association of these species with clinical symptoms was observed (P > 0.01) In general, species-specific nPCR allowed the detection of C. gracilis in 21.1% (12 of 57) and C. rectus in 23.3% (10 of 43)of the samples taken from primary endodontic infections. Findings confirmed the assertion that both C. gracilis and C. rectus participate in infections of endodontic origin and suggest a pathogenetic role with regard to periradicular diseases.

  5. MR imaging of rectus femoris origin injuries

    International Nuclear Information System (INIS)

    Ouellette, Hugue; Thomas, Bijoy J.; Nelson, Erik; Torriani, Martin

    2006-01-01

    To describe the MR imaging findings of acute and chronic rectus femoris origin (RFO) injuries. A retrospective review of pelvic and hip MR imaging procedures was performed over a 4-year period for detection of cases with injuries to the RFO. Subjects were classified as having either acute or chronic symptoms. MR imaging studies, radiographs, CT scans, radiology reports, medical records, and operative notes were reviewed. Imaging analysis was directed to assess injuries affecting the direct and indirect heads of the RFO. Concurrent osseous, cartilaginous and musculotendinous injuries were tabulated. The incidence of RFO injuries on MR imaging was 0.5% (17/3160). With the exception of one case of anterior inferior iliac spine apophysis avulsion and partial tear of the direct head of RFO, all subjects had indirect head of RFO injuries (acute injury 8/9, chronic injury 8/8). Partial tear of the direct head of RFO was less frequently seen (acute injury 3/9, chronic injury 2/8). Partial tears of the conjoint tendon were least frequent (acute 1/9, chronic 2/8). No full-thickness tears of the RFO were noted. Associated labral tears were seen in only one case, with no other concomitant abnormality of the articular cartilage or surrounding soft tissues. All RFO injuries were treated non-operatively. Injuries of the RFO are uncommon on MR examinations of pelvis/hips and may occur in a sequence progressing from indirect head injury to involvement of direct head and conjoint tendon in more severe cases. (orig.)

  6. Muscle-bone Interactions During Fracture Healing

    Science.gov (United States)

    2015-03-01

    muscle resection, isotopic or heterotopic minced muscle implants were placed immediately adjacent to the periosteum. Their control groups consisted of...interacting with surrounding muscle. Addition- ally, Utvag et al. showed that significant muscle injury and ab- sence of muscle by resection, or by traumatic

  7. Spontaneous rectus sheath hematoma: The utility of CT angiography

    Directory of Open Access Journals (Sweden)

    Antonio Pierro, MD

    2018-04-01

    Full Text Available We described the utility of computed tomography (CT angiography in detection of bleeding vessels for a rapid percutaneous arterial embolization of the spontaneous rectus sheath hematoma. A 70-year-old woman comes to our attention with acute abdominal pain and a low hemoglobin level. An unenhanced CT was performed demonstrating a large rectus sheath hematoma. A conservative management was initially established. Despite this therapy, the abdominal pain increased together with a further decrease of hemoglobin values. A CT angiography was then performed, demonstrating an active bleeding within the hematoma and addressing the patient to a rapid percutaneous arterial embolization. Keywords: Rectus sheath hematoma, Acute abdomen, Arterial embolization, CT angiography, Active bleeding

  8. Characteristics of acute groin injuries in the hip flexor muscles - a detailed MRI study in athletes

    DEFF Research Database (Denmark)

    Serner, A; Weir, A; Tol, J L

    2018-01-01

    acute hip flexor muscle injury were included. A total of 156 athletes presented with acute groin pain of which 33 athletes were included, median age 26 years (range 18-35). There were 16 rectus femoris, 12 iliacus, 7 psoas major, 4 sartorius, and 1 tensor fascia latae injury. Rectus femoris injuries...

  9. Comparison of Abdominal Muscles Thickness Changes Different Postures beween Non-Specific Chronic Low Back Pain Patients and Healthy Males by Ultrasonography

    Directory of Open Access Journals (Sweden)

    Omid Rasouli

    2010-01-01

    Conclusion: Abdominal muscles respond to postural changes and these muscles are automatically targeted by decreasing the seated stability. In non–specific chronic low back pain patients, activity of Transvers Abdominis was decreased and activity of Rectus Abdominis was increased.

  10. Magnetic resonance imaging findings after rectus femoris transfer surgery

    International Nuclear Information System (INIS)

    Gold, Garry E.; Asakawa, Deanna S.; Blemker, Silvia S.; Delp, Scott L.

    2004-01-01

    We describe the magnetic resonance (MR) imaging appearance of the knee flexor and extensor tendons after bilateral rectus femoris transfer and hamstring lengthening surgery in five patients (10 limbs) with cerebral palsy. Three-dimensional models of the path of the transferred tendon were constructed in all cases. MR images of the transferred and lengthened tendons were examined and compared with images from ten non-surgical subjects. The models showed that the path of the transferred rectus femoris tendon had a marked angular deviation near the transfer site in all cases. MR imaging demonstrated irregular areas of low signal intensity near the transferred rectus femoris and around the hamstrings in all subjects. Eight of the ten post-surgical limbs showed evidence of fluid near or around the transferred or lengthened tendons. This was not observed in the non-surgical subjects. Thus, MR imaging of patients with cerebral palsy after rectus femoris transfer and hamstring-lengthening surgery shows evidence of signal intensity and contour changes, even several years after surgery. (orig.)

  11. Rectus Fascia Sling for the Treatment of Total Urethral Incontinence ...

    African Journals Online (AJOL)

    Objectives: Urinary incontinence in patients with neurological disease is a major health problem. A modified rectus fascial sling has been assessed in incontinent male patients. Patients and Methods: Fourteen adult male patients with total incontinence due to neurogenic or post-traumatic and etiology were included in this ...

  12. [Pelvic reconstructions after bone tumor resection].

    Science.gov (United States)

    Anract, Philippe; Biau, David; Babinet, Antoine; Tomeno, Bernard

    2014-02-01

    The three more frequent primitive malignant bone tumour which concerned the iliac bone are chondrosarcoma, following Ewing sarcoma and osteosarcoma. Wide resection remains the most important part of the treatment associated with chemotherapy for osteosarcoma and the Ewing sarcoma. Iliac wing resections and obdurate ring don't required reconstruction. However, acetabular resections and iliac wing resection with disruption of the pelvic ring required reconstruction to provide acceptable functional result. Acetabular reconstruction remains high technical demanding challenge. After isolated acetabular resection or associated to obdurate ring, our usual method of reconstruction is homolateral proximal femoral autograft and total hip prosthesis but it is possible to also used : saddle prosthesis, Mac Minn prosthesis with auto or allograft, modular prosthesis or custom made prosthesis, massive allograft with or without prosthesis and femoro-ilac arthrodesis. After resection of the iliac wing plus acetabulum, reconstruction can be performed by femoro-obturatrice and femora-sacral arthrodesis, homolateral proximal femoral autograft and prosthesis, femoral medialisation, massive allograft and massive allograft. Carcinological results are lesser than resection for distal limb tumor, local recurrence rate range 17 to 45%. Functional results after Iliac wing and obdurate ring are good. However, acetabular reconstruction provide uncertain functional results. The lesser results arrive after hemipelvic or acetabular and iliac wing resection-reconstruction, especially when gluteus muscles were also resected. The most favourable results arrive after isolated acetabular or acetabular plus obturateur ring resection-reconstruction.

  13. Impact of low skeletal muscle mass and density on short and long-term outcome after resection of stage I-III colorectal cancer.

    Science.gov (United States)

    van Vugt, Jeroen L A; Coebergh van den Braak, Robert R J; Lalmahomed, Zarina S; Vrijland, Wietske W; Dekker, Jan W T; Zimmerman, David D E; Vles, Wouter J; Coene, Peter-Paul L O; IJzermans, Jan N M

    2018-06-06

    Preoperative low skeletal muscle mass and density are associated with increased postoperative morbidity in patients undergoing curative colorectal cancer (CRC) surgery. However, the long-term effects of low skeletal muscle mass and density remain uncertain. Patients with stage I-III CRC undergoing surgery, enrolled in a prospective observational cohort study, were included. Skeletal muscle mass and density were measured on CT. Patients with high and low skeletal muscle mass and density were compared regarding postoperative complications, disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). In total, 816 patients (53.9% males, median age 70) were included; 50.4% had low skeletal muscle mass and 64.1% low density. The severe postoperative complication rate was significantly higher in patients with low versus high skeletal muscle and density (20.9% versus 13.6%, p = 0.006; 20.0% versus 11.8%, p = 0.003). Low skeletal muscle mass (OR 1.91, p = 0.018) and density (OR 1.87, p = 0.045) were independently associated with severe postoperative complications. Ninety-day mortality was higher in patients with low skeletal muscle mass and density compared with patients with high skeletal muscle mass and density (3.6% versus 1.7%, p = 0.091; 3.4% versus 1.0%, p = 0.038). No differences in DFS were observed. After adjustment for covariates such as age and comorbidity, univariate differences in OS and CSS diminished. Low skeletal muscle mass and density are associated with short-term, but not long-term, outcome in patients undergoing CRC surgery. These findings recommend putting more emphasis on preoperative management of patients at risk for surgical complications, but do not support benefit for long-term outcome. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  14. Surgical Results in Unilateral Superior Oblique Muscle Palsy

    Directory of Open Access Journals (Sweden)

    Aylin Tenlik

    2014-08-01

    Full Text Available Objectives: To evaluate the surgical treatments and results of the patients with superior oblique muscle palsy (SOMP. Materials and Methods: Clinical charts of the patients with unilateral SOMP who were operated in our clinic between 1999 and 2009 were evaluated retrospectively. Patients’ demographics, preoperative signs, surgical procedure, complications, and final results were recorded. Results: Thirty-seven patients were included in the study, [21 (59% male, 15 (41% female]. The mean age was 20.6 years at the time of operation. The mean time interval between diagnosis and operation was 7.3 years. Postoperative follow-up period was 2.04 (ranging 1-10 years. Diplopia was determined in seven (18.9% patients, and abnormal head position in 36 (97.3% patients. Only inferior oblique tenotomy with distal muscle resection was performed in 25 patients. In addition, five patients had recession of the contralateral inferior rectus muscle and two patients had recession of the ipsilateral superior rectus muscle additional to inferior oblique tenotomy. Abnormal head position was completely improved in all of the patients postoperatively. The preoperative average score of the inferior oblique muscle (IOM overaction was +3.3±0.8, and postoperative overaction was found in only two patients (+1.5. There was statistically significant difference between the two periods (p<0.001. The average score of the superior oblique muscle hypofunction was -2.18 preoperatively, and in only three patients, the score was found -1.0 postoperatively. Difference between the two periods was statistically significant (p<0.001. While the preoperative average vertical deviation was 22 PD in primary position, none of the patients had hyperdeviation postoperatively. Diplopia was resolved in all seven affected patients postoperatively. Contralateral IOM hyperfunction was the most common complication (13.5%. Adherence syndrome was seen in none of the patients. Conclusion: It was found

  15. MRI estimation of extraocular muscle swelling in dysthyroid ophthalmopathy

    International Nuclear Information System (INIS)

    Watanabe, Yoshihiro; Kakisu, Yonetsugu; Hatakeyama, Masayuki; Asanagi, Kaoru

    1988-01-01

    The thickness and width of superior, inferior and medial rectus muscles were measured via T1-weighted coronal images using a 0.5 T superconducting MRI (magnetic resonance imaging) system in 10 patients with dysthyroid ophthalmopathy and 27 normal orbits. Lateral rectus muscles were not measured because the partial volume effect obscured their contours. Patients were divided into 3 groups according to the severity of ophthalmopathy. Group A had no ophthalmopathy, group B had corneal involvement or restricted eye movement, group C had optic nerve involvement. Mean muscle thickness increased in the order A, B and C. Mean rectus muscle width was normal in group A, but dramatically increased in group C, results suggesting that swelling of the extraocular muscles is a characteristic pathologic change in dysthyroid ophthalmopathy. It is concluded that MRI is a safe and useful method of evaluating the severity of and prognosing dysthyroid ophthalmopathy. (author)

  16. Core Muscle Activation in Suspension Training Exercises.

    Science.gov (United States)

    Cugliari, Giovanni; Boccia, Gennaro

    2017-02-01

    A quantitative observational laboratory study was conducted to characterize and classify core training exercises executed in a suspension modality on the base of muscle activation. In a prospective single-group repeated measures design, seventeen active male participants performed four suspension exercises typically associated with core training (roll-out, bodysaw, pike and knee-tuck). Surface electromyographic signals were recorded from lower and upper parts of rectus abdominis, external oblique, internal oblique, lower and upper parts of erector spinae muscles using concentric bipolar electrodes. The average rectified values of electromyographic signals were normalized with respect to individual maximum voluntary isometric contraction of each muscle. Roll-out exercise showed the highest activation of rectus abdominis and oblique muscles compared to the other exercises. The rectus abdominis and external oblique reached an activation higher than 60% of the maximal voluntary contraction (or very close to that threshold, 55%) in roll-out and bodysaw exercises. Findings from this study allow the selection of suspension core training exercises on the basis of quantitative information about the activation of muscles of interest. Roll-out and bodysaw exercises can be considered as suitable for strength training of rectus abdominis and external oblique muscles.

  17. Prostate resection - minimally invasive

    Science.gov (United States)

    ... thermotherapy; TUMT; Urolift; BPH - resection; Benign prostatic hyperplasia (hypertrophy) - resection; Prostate - enlarged - resection ... passing an instrument through the opening in your penis (meatus). You will be given general anesthesia (asleep ...

  18. Autologous grafting of extraocular muscles: experimental study in rabbits Transplante autólogo de musculatura ocular extrínseca: estudo experimental em coelhos

    Directory of Open Access Journals (Sweden)

    Jorge Meireles-Teixeira

    2005-06-01

    Full Text Available PURPOSE: To evaluate the feasibility of autologous extraocular muscle grafting as a type of muscle expansion surgery. METHODS: The left superior rectus muscle of twenty-nine rabbits was resected and this fragment was attached to the endpoint of the respective right superior rectus (test group. Thereafter, the superior rectus of the left eye was reattached to the sclera (control group. Both groups were examined during different postoperative periods in order to assess their outcomes. RESULTS: The presence of hyperemia was slightly more frequent in the grafted group. Secretion and muscle atrophy were negligible in both groups. Fibrosis was greater in grafted animals. These muscles were weaker than the control muscles, although the force required to split muscular parts was always greater than the physiological one. CONCLUSIONS: This surgical technique was reliable and useful if one intends to achieve muscle expansion without the intrinsic risks of dealing with heterologous/artificial materials.OBJETIVO: Avaliar a viabilidade do uso de segmentos de músculos oculares extrínsecos como expansores de tendões musculares. MÉTODOS: Vinte e nove coelhos tiveram seu músculo reto superior esquerdo ressecado e o fragmento de cada um foi transplantado para o reto superior contralateral (grupo-teste. Então, o reto superior esquerdo foi reinserido na esclera (grupo-controle. Os animais foram então examinados em diversos períodos pós-operatórios, até os seus sacrifícios, para que se avaliasse o desenrolar dessa técnica cirúrgica. RESULTADOS: A hiperemia foi maior entre os testes. A secreção e a atrofia muscular foram mínimas nos dois grupos. Houve maior presença de fibrose no grupo-teste, mas não tão expressiva a ponto de inviabilizar os efeitos da cirurgia. Esses músculos também se romperam mais facilmente do que os do grupo-controle, porém, a força de rompimento foi sempre bem maior do que aquela presente numa contração muscular normal

  19. Spindle Cell Hemangioendothelioma of the Temporal Muscle Resected with Zygomatic Osteotomy: A Case Report of an Unusual Intramuscular Lesion Mimicking Sarcoma

    Directory of Open Access Journals (Sweden)

    Tomohiro Minagawa

    2011-01-01

    Full Text Available Spindle cell hemangioendothelioma (SCH was originally described by Weiss and Enzinger (1986 as a low-grade angiosarcoma resembling both cavernous hemangioma and Kaposi's sarcoma. Recent studies suggest that SCH is a benign neoplasm or reactive lesion accompanying a congenital or acquired vascular malformation. Most SCHs present as one or more nodules affecting the dermis or subcutis of the distal extremities. Few reports describe SCH of the head and neck region; even fewer note intramuscular SCH. Here, we describe a case of SCH involving the temporal muscle mimicking soft tissue sarcoma, who had a successful surgical treatment with a coronal approach and zygomatic osteotomy.

  20. Cortical motor representation of the rectus femoris does not differ between the left and right hemisphere.

    Science.gov (United States)

    Ward, Sarah; Bryant, Adam L; Pietrosimone, Brian; Bennell, Kim L; Clark, Ross; Pearce, Alan J

    2016-06-01

    Transcranial magnetic stimulation (TMS) involves non-invasive magnetic stimulation of the brain, and can be used to explore the corticomotor excitability and motor representations of skeletal muscles. However there is a lack of motor mapping studies in the lower limb and few conducted in healthy cohorts. The cortical motor representations of muscles can vary between individuals in terms of center position and area despite having a general localized region within the motor cortex. It is important to characterize the normal range for these variables in healthy cohorts to be able to evaluate changes in clinical populations. TMS was used in this cross-sectional study to assess the active motor threshold (AMT) and cortical representation area for rectus femoris in 15 healthy individuals (11M/4F 27.3±5.9years). No differences were found between hemispheres (Left vs. Right P=0.130) for AMT. In terms of y-axis center position no differences were found between hemispheres (Left vs. Right P=0.539), or for the x-axis center position (Left vs. Right P=0.076). Similarly, no differences in calculated area of the motor representation were found (Left vs. Right P=0.699) indicating symmetry between hemispheres. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Inferior oblique muscle paresis as a sign of myasthenia gravis.

    Science.gov (United States)

    Almog, Yehoshua; Ben-David, Merav; Nemet, Arie Y

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (pmyasthenia gravis can be difficult, because the disease may mimic every pupil-sparing pattern of ocular misalignment. In addition diplopia caused by paresis of the inferior oblique muscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Acquired oculomotor muscle fibrosis in infant: case report

    Directory of Open Access Journals (Sweden)

    Carlos Ramos de Souza-Dias

    2011-06-01

    Full Text Available The authors report the case of a 5 year-old boy who up to 2 years old presented normal eyes, when his right eye started to deviate upward and laterally, until be hidden under the superior lid. At the surgery, a strong passive limitation to infraduction of this eye was felt. He had already been operated on in another clinic, but the surgeon could not succeed in hooking his superior rectus. With great difficulty, the only thing that we could do was a free tenotomy of the superior rectus. As the eye was equilibrated in a moderate abduction, we performed an 8 mm recession of the lateral rectus. As there was still a small hypertropia and exotropia postoperatively, we performed in a second operation an eight millimeters resection of the medial rectus, a recession with anterior transposition of the inferior oblique and an advancement of the inferior rectus according to the Romero-Apis technique, in order to avert circulatory problems to the anterior segment of the eye. As he presented a small blepharoptosis, we did, in a third surgery, a tarsectomy according to the Fasanella-Servat technique, with good result. He ended with good eye position, almost no limitation of the horizontal movements and - 3 limitation of up and down ductions. The magnetic resonance imaging showed an altered image of the superior rectus, suggesting fibrosis post myositis.

  3. [Repeat hepatic resections].

    Science.gov (United States)

    Popescu, I; Ciurea, S; Braşoveanu, V; Pietrăreanu, D; Tulbure, D; Georgescu, S; Stănescu, D; Herlea, V

    1998-01-01

    Five cases of iterative liver resections are presented, out of a total of 150 hepatectomies performed between 1.01.1995-1.01.1998. The resections were carried out for recurrent adenoma (one case), cholangiocarcinoma (two cases), hepatocellular carcinoma (one case), colo-rectal cancer metastasis (one case). Only cases with at least one major hepatic resection were included. Re-resections were more difficult than the primary resection due, first of all, to the modified vascular anatomy. Intraoperative ultrasound permitted localization of intrahepatic recurrences. Iterative liver resection appears to be the best therapeutical choice for patients with recurrent liver tumors.

  4. Fatigue-related changes in motor-unit synchronization of quadriceps muscles within and across legs

    NARCIS (Netherlands)

    Boonstra, T.W.; Daffertshofer, A.; van Ditshuizen, J.C.; van den Heuvel, M.R.C.; Hofman, C.; Willigenburg, N.W.; Beek, P.J.

    2008-01-01

    Two experiments were conducted to examine effects of muscle fatigue on motor-unit synchronization of quadriceps muscles (rectus femoris, vastus medialis, vastus lateralis) within and between legs. We expected muscle fatigue to result in an increased common drive to different motor units of

  5. Linear correlation between fractal dimension of surface EMG signal from Rectus Femoris and height of vertical jump

    International Nuclear Information System (INIS)

    Ancillao, Andrea; Galli, Manuela; Rigoldi, Chiara; Albertini, Giorgio

    2014-01-01

    Fractal dimension was demonstrated to be able to characterize the complexity of biological signals. The EMG time series are well known to have a complex behavior and some other studies already tried to characterize these signals by their fractal dimension. This paper is aimed at studying the correlation between the fractal dimension of surface EMG signal recorded over Rectus Femoris muscles during a vertical jump and the height reached in that jump. Healthy subjects performed vertical jumps at different heights. Surface EMG from Rectus Femoris was recorded and the height of each jump was measured by an optoelectronic motion capture system. Fractal dimension of sEMG was computed and the correlation between fractal dimension and eight of the jump was studied. Linear regression analysis showed a very high correlation coefficient between the fractal dimension and the height of the jump for all the subjects. The results of this study show that the fractal dimension is able to characterize the EMG signal and it can be related to the performance of the jump. Fractal dimension is therefore an useful tool for EMG interpretation

  6. Effect of age and carcass weight on quality traits of m. rectus abdominis from Charolais heifers.

    Science.gov (United States)

    Ellies-Oury, M P; Dumont, R; Perrier, G; Roux, M; Micol, D; Picard, B

    2017-04-01

    In practice cattle may be slaughtered at different combinations of age and weight. As each of these factors could affect meat quality traits, the present work aimed to identify which combination can be expected to increase overall meat quality of m. rectus abdominis of Charolais heifers. Totally, 40 heifers were slaughtered either at 26±1 or at 36±1 months of age. Young heifers were sampled at two different carcass weights (349±12 and 394±8 kg). Old heifers were also sampled at two different carcass weights (397±6 and 451±9 kg). The m. rectus abdominis was excised 24 h postmortem to determine metabolic enzyme activities, myosin heavy-chain isoform proportions, lipid contents, collagen content and collagen solubility. Shear force measurements were evaluated on raw and broiled meat after 14 days of ageing. Meat quality traits scored between 0 and 10 by sensory analysis. Increasing slaughter age from 26 to 36 months had no impact on either raw/broiled shear force (0.31⩽P⩽0.47) and/or meat quality traits (0.62⩽P⩽0.91) or on physicochemical properties of heifer's meat samples. Increasing carcass weight for a similar slaughter age of 26 months had also impact neither on meat quality traits (0.52⩽P⩽0.91) nor on muscular properties. On the contrary, increasing carcass weight for a similar slaughter age of 36 months had induced a decrease of muscular shear force (raw muscle; P=0.009) and a concomitant decrease of total collagen content (P=0.03). Nevertheless, no significant impact on meat quality traits was revealed by the sensorial panel (0.13⩽P⩽0.49). Metabolic enzyme activities (0.13⩽P⩽0.86) and myosin heavy-chain proportions (0.13⩽P⩽0.96) were not significantly impacted by slaughter age and carcass weight. Thus, the impact of increasing carcass weight and/or slaughter age in young Charolais heifers has a limited impact on meat quality traits and associated muscular characteristics. Modulating heifer's cycles (age and/or carcass weight in

  7. A new teaching model for demonstrating the movement of the extraocular muscles.

    Science.gov (United States)

    Iwanaga, Joe; Refsland, Jason; Iovino, Lee; Holley, Gary; Laws, Tyler; Oskouian, Rod J; Tubbs, R Shane

    2017-09-01

    The extraocular muscles consist of the superior, inferior, lateral, and medial rectus muscles and the superior and inferior oblique muscles. This study aimed to create a new teaching model for demonstrating the function of the extraocular muscles. A coronal section of the head was prepared and sutures attached to the levator palpebral superioris muscle and six extraocular muscles. Tension was placed on each muscle from a posterior approach and movement of the eye documented from an anterior view. All movements were clearly seen less than that of the inferior rectus muscle. To our knowledge, this is the first cadaveric teaching model for demonstrating the movements of the extraocular muscles. Clin. Anat. 30:733-735, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Effects of Barbell Deadlift Training on Submaximal Motor Unit Firing Rates for the Vastus Lateralis and Rectus Femoris

    Science.gov (United States)

    Stock, Matt S.; Thompson, Brennan J.

    2014-01-01

    Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units. PMID:25531294

  9. Effects of barbell deadlift training on submaximal motor unit firing rates for the vastus lateralis and rectus femoris.

    Directory of Open Access Journals (Sweden)

    Matt S Stock

    Full Text Available Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC assessment. Twenty-four previously untrained men (mean age  = 24 years were randomly assigned to training (n = 15 or control (n = 9 groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC and y-intercepts (pps of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70, but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units.

  10. Effects of barbell deadlift training on submaximal motor unit firing rates for the vastus lateralis and rectus femoris.

    Science.gov (United States)

    Stock, Matt S; Thompson, Brennan J

    2014-01-01

    Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units.

  11. Expression of schizophrenia biomarkers in extraocular muscles from patients with strabismus: an explanation for the link between exotropia and schizophrenia?

    Directory of Open Access Journals (Sweden)

    Andrea B. Agarwal

    2017-12-01

    Full Text Available Recent studies have implicated exotropia as a risk factor for schizophrenia. We determined whether schizophrenia biomarkers have abnormal levels of expression in extraocular muscles from patients with strabismus and explored whether differences in gene expression between medial and lateral rectus muscles may explain the specific association of schizophrenia with exotropia but not esotropia. Samples from horizontal extraocular muscles were obtained during strabismus surgery and compared with age- and muscle type-matched normal muscles from organ donors. We used PCR arrays to identify differences in gene expression among 417 signaling molecules. We then focused on established schizophrenia-related growth factors, cytokines, and regulators of the extracellular matrix. Among 36 genes with significantly altered gene expression in dysfunctional horizontal rectus muscles, over one third were schizophrenia-related: CTGF, CXCR4, IL1B, IL10RA, MIF, MMP2, NPY1R, NRG1, NTRK2, SERPINA3, TIMP1, TIMP2, and TNF (adjusted p value ≤ 0.016667. By PCR array, expression of three of these genes was significantly different in medial rectus muscles, while eleven were significantly altered in lateral rectus muscles. Comparing baseline levels between muscle types, three schizophrenia-related genes (NPY1R, NTRK2, TIMP2 had lower levels of expression in medial rectus muscles. Despite the surprisingly large number of schizophrenia-related genes with altered gene expression levels in dysfunctional muscles, the lack of specificity for medial rectus muscles undermines a model of shared, region-specific gene expression abnormalities between exotropia and schizophrenia, but rather suggests consideration of the alternative model: that exotropia-induced aberrant early visual experiences may enable and/or contribute as a causative factor to the development of schizophrenia.

  12. Endoscopic Rectus Abdominis and Prepubic Aponeurosis Repairs for Treatment of Athletic Pubalgia.

    Science.gov (United States)

    Matsuda, Dean K; Matsuda, Nicole A; Head, Rachel; Tivorsak, Tanya

    2017-02-01

    Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia.

  13. Extraocular muscle proprioception and eye position.

    Science.gov (United States)

    Pettorossi, V E; Ferraresi, A; Draicchio, F; Errico, P; Santarelli, R; Manni, E

    1995-03-01

    In the lamb, acute unilateral section of the ophthalmic branch induced in the ipsilateral eye occasional oscillations of the resting position and misalignment of the horizontal vestibulo-ocular reflex (HVOR) with respect to the stimulus. Additional electrolytic lesion of the cells innervating the proprioceptors of the medial rectus muscle, or of the lateral rectus muscle in the contralateral semilunar ganglion, provoked a 4 degrees-7 degrees consensual eye deviation towards and away from the lesioned side, respectively. The optokinetic beating field was similarly deviated. Under these experimental conditions, HVOR showed enhanced gain and marked misalignment in both eyes. Therefore, the selective suppression of muscular proprioceptive input deviated both eyes towards the direction opposite to the muscle whose gangliar proprioceptive representation has been destroyed.

  14. [Abdominothoracic esophageal resection according to Ivor Lewis with intrathoracic anastomosis : standardized totally minimally invasive technique].

    Science.gov (United States)

    Runkel, N; Walz, M; Ketelhut, M

    2015-05-01

    The clinical and scientific interest in minimally invasive techniques for esophagectomy (MIE) are increasing; however, the intrathoracic esophagogastric anastomosis remains a surgical challenge and lacks standardization. Surgeons either transpose the anastomosis to the cervical region or perform hybrid thoracotomy for stapler access. This article reports technical details and early experiences with a completely laparoscopic-thoracoscopic approach for Ivor Lewis esophagectomy without additional thoracotomy. The extent of radical dissection follows clinical guidelines. Laparoscopy is performed with the patient in a beach chair position and thoracoscopy in a left lateral decubitus position using single lung ventilation. The anvil of the circular stapler is placed transorally into the esophageal stump. The specimen and gastric conduit are exteriorized through a subcostal rectus muscle split incision. The stapler body is placed into the gastric conduit and both are advanced through the abdominal mini-incision transhiatally into the right thoracic cavity, where the anastomosis is constructed. Data were collected prospectively and analyzed retrospectively. A total of 23 non-selected consecutive patients (mean age 69 years, range 46-80 years) with adenocarcinoma (n = 19) or squamous cell carcinoma (n = 4) were surgically treated between June 2010 and July 2013. Neoadjuvant therapy was performed in 15 patients resulting in 10 partial and 4 complete remissions. There were no technical complications and no conversions. Mean operative time was 305 min (range 220-441 min). The median lymph node count was 16 (range 4-42). An R0 resection was achieved in 91 % of patients and 3 anastomotic leaks occurred which were successfully managed endoscopically. There were no postoperative deaths. The intrathoracic esophagogastric anastomosis during minimally invasive Ivor Lewis esophagectomy can be constructed in a standardized fashion without an additional thoracotomy

  15. Successful repair of injury to the eyelid, lacrimal passage, and extraocular muscle

    Directory of Open Access Journals (Sweden)

    Shah, Shreya Mehul

    2016-03-01

    Full Text Available Introduction: Injury is a known cause of monocular blindness. Ocular trauma may affect lacrimal canaliculi and the extraocular muscle. We report this case as it includes injury to lid, lacrimal canaliculi and inferior rectus. Case description: A 25-year-old male presented with an injury caused by a sharp object that resulted in a conjunctival tear, lid tear involving the lacrimal canal, and rupture of the inferior rectus muscle. All of the structures were repaired successfully during a single procedure. Conclusion: An extraocular injury involving the conjunctiva, lid, lacrimal passages, and extraocular muscles can be repaired successfully during a single procedure.

  16. Development of estimation system of knee extension strength using image features in ultrasound images of rectus femoris

    Science.gov (United States)

    Murakami, Hiroki; Watanabe, Tsuneo; Fukuoka, Daisuke; Terabayashi, Nobuo; Hara, Takeshi; Muramatsu, Chisako; Fujita, Hiroshi

    2016-04-01

    The word "Locomotive syndrome" has been proposed to describe the state of requiring care by musculoskeletal disorders and its high-risk condition. Reduction of the knee extension strength is cited as one of the risk factors, and the accurate measurement of the strength is needed for the evaluation. The measurement of knee extension strength using a dynamometer is one of the most direct and quantitative methods. This study aims to develop a system for measuring the knee extension strength using the ultrasound images of the rectus femoris muscles obtained with non-invasive ultrasonic diagnostic equipment. First, we extract the muscle area from the ultrasound images and determine the image features, such as the thickness of the muscle. We combine these features and physical features, such as the patient's height, and build a regression model of the knee extension strength from training data. We have developed a system for estimating the knee extension strength by applying the regression model to the features obtained from test data. Using the test data of 168 cases, correlation coefficient value between the measured values and estimated values was 0.82. This result suggests that this system can estimate knee extension strength with high accuracy.

  17. Current concepts in MRI of rectus femoris musculotendinous (myotendinous) and myofascial injuries in elite athletes

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, A., E-mail: Kassarjian@mac.com [Consultant Radiologist, Corades, S. L., Calle Galeon 2, 28220 Majadahonda, Madrid (Spain); Rodrigo, R.M., E-mail: rmrodrigo@resonanciamagneticabilbao.com [Resonancia Magnetica Bilbao, Hospital San Francisco Javier, Gordoniz 12, 40010 Bilbao, Vizcaya, Basque Country (Spain); Santisteban, J.M., E-mail: j.santisteban@athletic-club.net [Medical Services, Athletic Club Bilbao, Basurto Medical Institute, Faculty of Medicine and Odontology, University of the Basque Country, Barrio de Garaioltza 147, 48197 Lezama, Vizcaya, Basque Country (Spain)

    2012-12-15

    Rectus femoris injuries are extremely common in athletes, particularly in soccer players, rugby player, and sprinters. Magnetic resonance imaging (MRI) plays a key role in diagnosis, prognosis, and rehabilitation of these injuries. The current article discusses current concepts in the diagnosis and treatment of rectus femoris injuries in elite athletes, including a discussion of the less well known myofascial injuries and key prognostic factors as seen at MR imaging.

  18. Current concepts in MRI of rectus femoris musculotendinous (myotendinous) and myofascial injuries in elite athletes

    International Nuclear Information System (INIS)

    Kassarjian, A.; Rodrigo, R.M.; Santisteban, J.M.

    2012-01-01

    Rectus femoris injuries are extremely common in athletes, particularly in soccer players, rugby player, and sprinters. Magnetic resonance imaging (MRI) plays a key role in diagnosis, prognosis, and rehabilitation of these injuries. The current article discusses current concepts in the diagnosis and treatment of rectus femoris injuries in elite athletes, including a discussion of the less well known myofascial injuries and key prognostic factors as seen at MR imaging.

  19. Characteristic MR image finding of squatting exercise-induced rhabdomyolysis of the thigh muscles.

    Science.gov (United States)

    Yeon, Eung K; Ryu, Kyung N; Kang, Hye J; Yoon, So H; Park, So Y; Park, Ji S; Jin, Wook

    2017-04-01

    To describe the characteristic MRI appearance of squatting-induced rhabdomyolysis involving the thigh muscles. This study consisted of 10 cases obtained at 3 institutions from 2005 to 2015. A retrospective review was performed to obtain clinical information and MR scans for rhabdomyolysis of the thigh muscles. MRI was analyzed according to the distribution and degree of muscle involvement; the degree was assessed and graded as normal, mild or prominent. The mean patient age was 20.2 years (range, 15-24 years), and 7 of the 10 patients were male. All patients had history of excessive squatting action, suffered clinically from bilateral thigh pain and were confirmed to have rhabdomyolysis through analysis of serum creatine kinase (CK) levels. All of the patients (10/10) exhibited diffuse mild to prominent degree involvement of the anterior thigh muscles according to fluid-sensitive MR sequences. Among the anterior thigh muscles, the rectus femoris was spared in 8 patients (8/10) and mild degree involved in 2 patients (2/10). Thus, no cases exhibited prominent degree involvement of the rectus femoris muscle. Preservation of the rectus femoris muscle on MRI in squatting-induced rhabdomyolysis may be useful for differentiating rhabdomyolysis from other aetiologies. Advances in knowledge: Preservation of rectus femoris on MRI is distinguishable finding in squatting-induced rhabdomyolysis and reflects the functional anatomy of anterior thigh muscles.

  20. Anteriorization of the Normally Acting Inferior Oblique Muscles to Treat Dissociated Vertical Deviation Associated With Juvenile Glaucoma.

    Science.gov (United States)

    Kassem, Rehab Rashad

    2017-10-09

    A case of dissociated vertical deviation, ptosis, and juvenile glaucoma is described. J deformity anteriorization of the normally acting inferior oblique muscles was chosen to preserve the superior fornix for glaucoma surgeries by avoiding superior rectus recession and to prevent narrowing of the palpebral fissure by avoiding an inferior rectus tuck. [J Pediatr Ophthalmol Strabismus. 2017;54:e63-e66.]. Copyright 2017, SLACK Incorporated.

  1. Comparative anatomy of the extraocular muscles in four Myliobatoidei rays (Batoidea, Myliobatiformes).

    Science.gov (United States)

    Cunha, Carlo M; Oliveira, Luciano E; Kfoury, José R

    2016-05-01

    Extraocular muscles are classically grouped as four rectus and two oblique muscles. However, their description and potential associations with species behavior are limited. The objective was to characterize extraocular muscles in four Myliobatoidei rays from diverse habitats with divergent behaviors. Heads (10 per species) of Dasyatis hypostigma, Gymnura altavela, Mobula thurstoni and Pteroplatytrygon violacea were decalcified and dissected to characterize and describe extraocular muscles. Principal component analysis (PCA) was used to evaluate relationships between muscle length and species; for P. violacea, D. hypostigma and G. altavela, these were qualitatively and quantitatively consistent with the general pattern of extraocular muscles in vertebrates. In contrast, for M. thurstoni, the two oblique muscles were completely fused and there was a seventh extraocular muscle, named m. lateral rectus β (both were apparently novel findings in this species). There were also significant differences in eye disposition in the chondrocranium. The PCA axis 1 (rectus muscles) and PCA axis 2 (oblique muscles) accounted for 98.47% of data variability. Extraocular muscles had significant differences in length and important anatomical differences among sampled species that facilitated grouping species according to their life history. In conclusion, extraocular muscles are not uniform in all vertebrate species, thereby providing another basis for comparative studies. © 2016 Anatomical Society.

  2. Thyroid-Associated Orbitopathy with Superior Oblique Muscle Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Horng-Jiun Wu

    2004-02-01

    Full Text Available A 29-year-old male with a 5-year-history of hyperthyroidism complained of diplopia and proptosis. After subtotal thyroidectomy, he still had diplopia in a certain gaze. Computerized tomography showed inferior rectus muscle enlargement in the right eye and inferior rectus, medial rectus, and superior oblique muscle enlargement in the left eye. Ocular examination with the cover and uncover test revealed hyperphoria and exophoria in the left eye. The upward gaze of the right eye was more limited than that of the left eye. Since superior oblique muscle involvement in patients with thyroid orbitopathy is quite rare, we discuss its effect on ocular motility in patients with thyroid-associated orbitopathy.

  3. Computed tomography in endocrine orbitopathy: Effects of different gantry tilt and patient positioning on measurements of eye muscle thickness, and possibilities for correction

    International Nuclear Information System (INIS)

    Markl, A.; Hilbertz, T.; Mayr, B.; Lissner, J.; Pickardt, C.R.

    1986-01-01

    Thickening of eye muscles in endocrine orbitopathy can be demonstrated particularly impressively in coronary computed tomograms. However, when measuring the height and width of rectus eye muscles manifesting pathologic changes, the measurement is increased by a deviation from the coronary section plane; this is due to different tilting of the gantry. This often leads to an incorrect stage classification and makes objective observation of the course (e.g., under therapy) impossible. By converting the measured values into the actual extent of the muscles by means of the cosine set, appreciable changes in the pattern and frequency of affection of the rectus eye muscles were found in 121 patients examined. (orig.) [de

  4. Addition of rectus sheath relaxation incisions to emergency midline laparotomy for peritonitis to prevent fascial dehiscence.

    Science.gov (United States)

    Marwah, Sanjay; Marwah, Nisha; Singh, Mandeep; Kapoor, Ajay; Karwasra, Rajender Kumar

    2005-02-01

    The incidence of fascial dehiscence and incisional hernia after two methods for abdominal wound closure (rectus sheath relaxation incisions and conventional mass closure) was studied in a randomized prospective clinical trial in a consecutive series of 100 patients undergoing midline laparotomy for peritonitis. The two groups were well matched for etiologies of peritonitis, the surgical procedures performed, and the presence of known risk factors for fascial dehiscence. Fifty patients each were randomized either to the conventional continuous mass closure procedure or the rectus sheath relaxation incision technique (designed to increase wound elasticity and decrease tension in the suture line) using identical polypropylene sutures. The incidence of postoperative complications such as duration of ileus, chest infection, and wound infection were not statistically different between the two groups. The intensity of postoperative pain in the rectus sheath relaxation incision group was significantly less. The incidence of wound hematoma was significantly increased in the rectus sheath relaxation incision group. The incidences of fascial dehiscence (16% vs,28%; p cases of peritonitis using the rectus sheath relaxation technique is safe and less painful, provides increased wound elasticity and decreased tension on the suture line, and significantly decreases the incidence of wound dehiscence.

  5. Medial rectus Faden operations with or without recession for partially accommodative esotropia associated with a high accommodative convergence to accommodation ratio.

    Science.gov (United States)

    Akar, Serpil; Gokyigit, Birsen; Sayin, Nihat; Demirok, Ahmet; Yilmaz, Omer Faruk

    2013-01-01

    To evaluate the results of Faden operations on the medial rectus (MR) muscles with or without recession for the treatment of partially accommodative esotropia associated with a high accommodative convergence to accommodation (AC : A) ratio and to determine whether there was a decrease in the effects of posterior fixation over time. In this retrospective study, 108 of 473 patients who underwent surgery for partially accommodative esotropia with a high AC : A ratio received Faden operations on both MR muscles, and 365 received symmetric MR muscle recessions combined with a Faden operation. For the Faden operation, a satisfactory outcome of 76.9% at 1 month postoperation, decreased to 71.3% by the final follow-up visit (mean 4.8 years). A moderate positive correlation was observed between the increase in the postoperative near deviation and postoperative time. For the Faden operations combined with MR recession, a satisfactory outcome of 78.9% at 1 month post-operation, decreased to 78.4% by the final follow-up visit. A Faden operation of the MR muscles with or without recession is an effective surgical option for treating partially accommodative esotropia associated with a high AC : A ratio. For Faden operations of the MR muscles without recession, the effects of the posterior fixation decline over time.

  6. A Case of Postsurgical Necrotizing Fasciitis Invading the Rectus Abdominis Muscle and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Francesco Carbonetti

    2014-01-01

    Full Text Available Necrotizing fasciitis is a life-threatening, soft tissue infection and an early diagnosis is needed to permit a prompt surgical and medical intervention. Due to the high fatal potential of the disease complications, the radiologist should distinguish necrotizing fasciitis from the most common soft tissue infections, in order to permit a prompt surgical and medical treatment. We present a case of a wide necrotizing fasciitis who presented at our emergency department and we also provide the basic tools, through a review of the literature, for the general radiologist to distinguish, with computed tomography and magnetic resonance imaging, necrotizing fasciitis from the most common infections that could present during our routine practice.

  7. Small bowel resection

    Science.gov (United States)

    ... Ileostomy and your diet Ileostomy - caring for your stoma Ileostomy - changing your pouch Ileostomy - discharge Ileostomy - what to ask your doctor Low-fiber diet Preventing falls Small bowel resection - discharge Surgical wound care - open Types of ileostomy Ulcerative colitis - discharge When ...

  8. Large bowel resection

    Science.gov (United States)

    ... blockage in the intestine due to scar tissue Colon cancer Diverticular disease (disease of the large bowel) Other reasons for bowel resection are: Familial polyposis (polyps are growths on the lining of the colon or rectum) Injuries that damage the large bowel ...

  9. Combined Gluteus and Pudendal Thigh Flap Reconstruction of Vaginal Defects following Robotic Abdominoperineal Resection

    Directory of Open Access Journals (Sweden)

    Kasandra R. Dassoulas, MD

    2017-09-01

    Full Text Available Summary:. Low-lying rectal cancers are being treated more frequently with robotic-assisted abdominoperineal resection, obviating the need for laparotomy and the ability to raise vertical rectus abdominis musculocutaneous flaps. For female patients, posterior vaginectomy often accompanies the resection. Combined pudendal thigh flaps as an extension of bilateral gluteus advancement flaps allow for posterior vaginal resurfacing with thin pliable fasciocutaneous flaps, which rest on the gluteal flap soft-tissue bulk that obliterates the pelvic dead space. For patients with advanced cancers who have had neoadjuvant chemoradiation, the pudendal skin paddle can be planned more laterally to bring in healthier medial thigh skin. The donor incisions lie within the gluteal cleft and crease and groin creases recapitulating normal perineal anatomy and aesthetics.

  10. [Variation of muscle mass and weight in critical patient].

    Science.gov (United States)

    Valls-Matarín, J; del Cotillo-Fuente, M; Grané-Mascarell, N; Quintana, S

    2015-01-01

    Quantify the muscle mass and body weight variation in critically ill patients and to identify associated factors. A descriptive follow-up study. Data for demographic variables, body weight, fluid balance, daily kilocalories, the amount of sedation and muscle relaxants received and motor physiotherapy applied were collected. Three consecutive measurements were performed in the brachial biceps and quadriceps rectus by using ultrasound, upon admission and every 5 days until discharge. 68 patients were included. Average age was of 73.5 [57-78,5] years. The median length of stay was 9.5 [5.5 -15] days. The median 16 (SD=5.7) daily kilocalories per kg/weight, 91.2% received sedation, 44.1% received muscle relaxants and 20% received physiotherapy. The patients presented a muscle wasting of 4.9 (SD=3.9)mm, p <.001 in the brachial biceps and 5.6 (SD=4.8)mm, p <.001 in the quadriceps rectus. Regression analysis selected the length of stay and the muscle relaxants are the most influential variables in the brachial biceps muscle wasting (R2=0.4), and length of stay as the most influential in the quadriceps rectus muscle wasting (R2=0.3). Patient's mean body weight on admission was of 81.1 (SD=15)kg and 81.2 (SD=14.2)kg on discharge, p=.95. The critically ill patient presents a significant muscle waste related with the length of stay and the treatment received with muscle relaxants. Patients are being discharged with a similar body weight to which they were admitted but with a significant reduction of muscle mass. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  11. Immunohistochemical evaluation of fibrillar components of the extracellular matrix of transversalis fascia and anterior abdominal rectus sheath in men with inguinal hernia

    Directory of Open Access Journals (Sweden)

    Rogério De Oliveira Gonçalves

    Full Text Available OBJECTIVE: to evaluate the role of fibrillar extracellular matrix components in the pathogenesis of inguinal hernias. METHODS: samples of the transverse fascia and of the anterior sheath of the rectus abdominis muscle were collected from 40 men aged between 20 and 60 years with type II and IIIA Nyhus inguinal hernia and from 10 fresh male cadavers (controls without hernia in the same age range. The staining technique was immunohistochemistry for collagen I, collagen III and elastic fibers; quantification of fibrillar components was performed with an image analysis processing software. RESULTS: no statistically significant differences were found in the amount of elastic fibers, collagen I and collagen III, and the ratio of collagen I / III among patients with inguinal hernia when compared with subjects without hernia. CONCLUSION: the amount of fibrillar extracellular matrix components did not change in patients with and without inguinal hernia.

  12. MALDI-TOF MS contribution to the diagnosis of Campylobacter rectus multiple skull base and brain abscesses

    Directory of Open Access Journals (Sweden)

    D. Martiny

    2017-09-01

    Full Text Available Campylobacter rectus is rarely associated with invasive infection. Both the isolation and the identification requirements of C. rectus are fastidious, probably contributing to an underestimation of its burden. We report the case of a 66-year-old man who developed several skull base and intracerebral abscesses after dental intervention. Campylobacter rectus was isolated from the brain biopsy. Within 45 minutes of reading the bacterial plate, the strain was accurately identified by MALDI-TOF MS. This rapid identification avoided the extra costs and delays present with 16S rRNA gene sequencing and allowed for a rapid confirmation of the adequacy of the empirical antibiotic treatment.

  13. Muscle Activation during Push-Ups with Different Suspension Training Systems

    Directory of Open Access Journals (Sweden)

    Joaquin Calatayud, Sebastien Borreani, Juan C. Colado, Fernando F Martín, Michael E. Rogers

    2014-09-01

    Full Text Available The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29 performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC. Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001. Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation.

  14. Middle cerebral artery blood velocity depends on cardiac output during exercise with a large muscle mass

    NARCIS (Netherlands)

    Ide, K.; Pott, F.; van Lieshout, J. J.; Secher, N. H.

    1998-01-01

    We tested the hypothesis that pharmacological reduction of the increase in cardiac output during dynamic exercise with a large muscle mass would influence the cerebral blood velocity/perfusion. We studied the relationship between changes in cerebral blood velocity (transcranial Doppler), rectus

  15. Variability of femoral muscle attachments.

    Science.gov (United States)

    Duda, G N; Brand, D; Freitag, S; Lierse, W; Schneider, E

    1996-09-01

    Analytical and experimental models of the musculoskeletal system often assume single values rather than ranges for anatomical input parameters. The hypothesis of the present study was that anatomical variability significantly influences the results of biomechanical analyses, specifically regarding the moment arms of the various thigh muscles. Insertions and origins of muscles crossing or attaching to the femur were digitized in six specimens. Muscle volumes were measured; muscle attachment area and centroid location were computed. To demonstrate the influence of inter-individual anatomic variability on a mechanical modeling parameter, the corresponding range of muscle moment arms were calculated. Standard deviations, as a percentage of the mean, were about 70% for attachment area and 80% for muscle volume and attachment centroid location. The resulting moment arms of the m. gluteus maximus and m. rectus femoris were especially sensitive to anatomical variations (SD 65%). The results indicate that sensitivity to anatomical variations should be analyzed in any investigation simulating musculoskeletal interactions. To avoid misinterpretations, investigators should consider using several anatomical configurations rather than relying on a mean data set.

  16. Mechanical characterisation of porcine rectus sheath under uniaxial and biaxial tension.

    LENUS (Irish Health Repository)

    Lyons, Mathew

    2014-06-03

    Incisional hernia development is a significant complication after laparoscopic abdominal surgery. Intra-abdominal pressure (IAP) is known to initiate the extrusion of intestines through the abdominal wall, but there is limited data on the mechanics of IAP generation and the structural properties of rectus sheath. This paper presents an explanation of the mechanics of IAP development, a study of the uniaxial and biaxial tensile properties of porcine rectus sheath, and a simple computational investigation of the tissue. Analysis using Laplace׳s law showed a circumferential stress in the abdominal wall of approx. 1.1MPa due to an IAP of 11kPa, commonly seen during coughing. Uniaxial and biaxial tensile tests were conducted on samples of porcine rectus sheath to characterise the stress-stretch responses of the tissue. Under uniaxial tension, fibre direction samples failed on average at a stress of 4.5MPa at a stretch of 1.07 while cross-fibre samples failed at a stress of 1.6MPa under a stretch of 1.29. Under equi-biaxial tension, failure occurred at 1.6MPa with the fibre direction stretching to only 1.02 while the cross-fibre direction stretched to 1.13. Uniaxial and biaxial stress-stretch plots are presented allowing detailed modelling of the tissue either in silico or in a surrogate material. An FeBio computational model of the tissue is presented using a combination of an Ogden and an exponential power law model to represent the matrix and fibres respectively. The structural properties of porcine rectus sheath have been characterised and add to the small set of human data in the literature with which it may be possible to develop methods to reduce the incidence of incisional hernia development.

  17. Muscle Activation during Push-Ups with Different Suspension Training Systems.

    Science.gov (United States)

    Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan C; Martín, Fernando F; Rogers, Michael E; Behm, David G; Andersen, Lars L

    2014-09-01

    The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation. Key PointsCompared with standard push-ups on the floor, suspended push-ups increase core muscle activation.A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity.More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation.A suspended push-up is an effective method to achieve high muscle activity levels in the ABS.

  18. Clinical classification of cancer cachexia: phenotypic correlates in human skeletal muscle.

    Directory of Open Access Journals (Sweden)

    Neil Johns

    Full Text Available BACKGROUND: Cachexia affects the majority of patients with advanced cancer and is associated with a reduction in treatment tolerance, response to therapy, and duration of survival. One impediment towards the effective treatment of cachexia is a validated classification system. METHODS: 41 patients with resectable upper gastrointestinal (GI or pancreatic cancer underwent characterisation for cachexia based on weight-loss (WL and/or low muscularity (LM. Four diagnostic criteria were used >5%WL, >10%WL, LM, and LM+>2%WL. All patients underwent biopsy of the rectus muscle. Analysis included immunohistochemistry for fibre size and type, protein and nucleic acid concentration, Western blots for markers of autophagy, SMAD signalling, and inflammation. FINDINGS: Compared with non-cachectic cancer patients, patients with LM or LM+>2%WL, mean muscle fibre diameter was reduced by about 25% (p = 0.02 and p = 0.001 respectively. No significant difference in fibre diameter was observed if patients had WL alone. Regardless of classification, there was no difference in fibre number or proportion of fibre type across all myosin heavy chain isoforms. Mean muscle protein content was reduced and the ratio of RNA/DNA decreased in patients with either >5%WL or LM+>2%WL. Compared with non-cachectic patients, SMAD3 protein levels were increased in patients with >5%WL (p = 0.022 and with >10%WL, beclin (p = 0.05 and ATG5 (p = 0.01 protein levels were increased. There were no differences in phospho-NFkB or phospho-STAT3 levels across any of the groups. CONCLUSION: Muscle fibre size, biochemical composition and pathway phenotype can vary according to whether the diagnostic criteria for cachexia are based on weight loss alone, a measure of low muscularity alone or a combination of the two. For intervention trials where the primary end-point is a change in muscle mass or function, use of combined diagnostic criteria may allow identification of a more

  19. Limb muscle quality and quantity in elderly adults with dynapenia but not sarcopenia: An ultrasound imaging study.

    Science.gov (United States)

    Chang, Ke-Vin; Wu, Wei-Ting; Huang, Kuo-Chin; Jan, Wei Han; Han, Der-Sheng

    2018-03-28

    Dynapenia is prevalent in people with reduced skeletal muscle mass, i.e. sarcopenia, but a certain population develops muscle strength loss despite having normal skeletal muscle volume. To date, studies investigating muscle quality and quantity in groups with dynapenia but not sarcopenia are limited. Echogenicity and thickness of the biceps brachii, triceps brachii, rectus femoris, and medial gastrocnemius muscles were measured using high-resolution ultrasonography in 140 community-dwelling elderly adults. Participants with decreased handgrip strength but normal muscular volume were diagnosed as having dynapenia without sarcopenia. A multivariate regression model was used to analyze the association between dynapenia and ultrasound indicators of the sampled muscle expressed as odds ratio (OR) and 95% confidence interval (CI). A total of 140 participants were recruited for the study, 12.6% (n = 18) of whom had dynapenia. The dynapenia group had a higher mean age, higher proportion of women, slower fast gait speed, reduced handgrip strength, and decreased thicknesses of the biceps brachii, rectus femoris, and medial gastrocnemius muscles. On multivariate logistic regression analysis, dynapenia was associated with older age (OR, 1.18; 95% CI, 1.05 to 1.33), higher body mass index (OR, 1.28; 95% CI, 1.05 to 1.64), and decreased thicknesses of the rectus femoris (OR, 0.01; 95% CI, <0.01 to 0.24) and medial gastrocnemius muscles (OR, 0.03; 95% CI, <0.01 to 0.61). Dynapenia without sarcopenia is associated with decreased thicknesses of the rectus femoris and medial gastrocnemius muscles, an association that remains significant after adjustment for demographics, body composition, and physical performance. Ultrasound measurements of lower-limb muscle thickness can be considered an auxiliary criterion for evaluating dynapenia. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. [Endoscopic full-thickness resection].

    Science.gov (United States)

    Meier, B; Schmidt, A; Caca, K

    2016-08-01

    Conventional endoscopic resection techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are powerful tools for the treatment of gastrointestinal (GI) neoplasms. However, those techniques are limited to the superficial layers of the GI wall (mucosa and submucosa). Lesions without lifting sign (usually arising from deeper layers) or lesions in difficult anatomic positions (appendix, diverticulum) are difficult - if not impossible - to resect using conventional techniques, due to the increased risk of complications. For larger lesions (>2 cm), ESD appears to be superior to the conventional techniques because of the en bloc resection, but the procedure is technically challenging, time consuming, and associated with complications even in experienced hands. Since the development of the over-the-scope clips (OTSC), complications like bleeding or perforation can be endoscopically better managed. In recent years, different endoscopic full-thickness resection techniques came to the focus of interventional endoscopy. Since September 2014, the full-thickness resection device (FTRD) has the CE marking in Europe for full-thickness resection in the lower GI tract. Technically the device is based on the OTSC system and combines OTSC application and snare polypectomy in one step. This study shows all full-thickness resection techniques currently available, but clearly focuses on the experience with the FTRD in the lower GI tract.

  1. Effects of age and inactivity due to prolonged bed rest on atrophy of trunk muscles.

    Science.gov (United States)

    Ikezoe, Tome; Mori, Natsuko; Nakamura, Masatoshi; Ichihashi, Noriaki

    2012-01-01

    This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily living involving walking independently (n = 28) and dependent elderly group who were chronically bedridden (n = 13). The thickness of the following six trunk muscles was measured by B-mode ultrasound: the rectus abdominis, external oblique, internal oblique, transversus abdominis, thoracic erector spinae (longissimus) and lumbar multifidus muscles. All muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group. The thicknesses of all muscles in the dependent elderly group was significantly smaller than that in the young group, whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles. In conclusion, our results suggest that: (1) age-related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women; (2) atrophy associated with chronic bed rest was more marked in the antigravity muscles, such as the back and transversus abdominis.

  2. Endoscopic resection of subepithelial tumors.

    Science.gov (United States)

    Schmidt, Arthur; Bauder, Markus; Riecken, Bettina; Caca, Karel

    2014-12-16

    Management of subepithelial tumors (SETs) remains challenging. Endoscopic ultrasound (EUS) has improved differential diagnosis of these tumors but a definitive diagnosis on EUS findings alone can be achieved in the minority of cases. Complete endoscopic resection may provide a reasonable approach for tissue acquisition and may also be therapeutic in case of malignant lesions. Small SET restricted to the submucosa can be removed with established basic resection techniques. However, resection of SET arising from deeper layers of the gastrointestinal wall requires advanced endoscopic methods and harbours the risk of perforation. Innovative techniques such as submucosal tunneling and full thickness resection have expanded the frontiers of endoscopic therapy in the past years. This review will give an overview about endoscopic resection techniques of SET with a focus on novel methods.

  3. Quality control and primo-diagnosis of transurethral bladder resections with full-field OCT

    Science.gov (United States)

    Montagne, P.; Ducesne, I.; Anract, J.; Yang, C.; Sibony, M.; Beuvon, F.; Delongchamps, N. B.; Dalimier, E.

    2017-02-01

    Transurethral resections are commonly used for bladder cancer diagnosis, treatment and follow-up. Cancer staging relies largely on the analysis of muscle in the resections; however, muscle presence is uncertain at the time of the resection. An extemporaneous quality control tool would be of great use to certify the presence of muscle in the resection, and potentially formulate a primo-diagnosis, in order to ensure optimum patient care. Full-field optical coherence tomography (FFOCT) offers a fast and non-destructive method of obtaining images of biological tissues at ultrahigh resolution (1μm in all 3 directions), approaching traditional histological sections. This study aimed to evaluate the potential of FFOCT for the quality control and the primo-diagnosis of transurethral bladder resections. Over 70 transurethral bladder resections were imaged with FFOCT within minutes, shortly after excision, and before histological preparation. Side-by-side comparison with histology allowed to establish reading criteria for the presence of muscle and cancer in particular. Images of 24 specimens were read blindly by three non-pathologists readers: two resident urologists and a junior bio-medical engineer, who were asked to notify the presence of muscle and tumor. Results showed that after appropriate training, 96% accuracy could be obtained on both tumour and muscle detection. FFOCT is a fast and nondestructive imaging technique that provides analysis results concordant with histology. Its implementation as a quality control and primo-diagnosis tool for transurethral bladder resections in the urology suite is feasible and lets envision high value for the patient.

  4. Learning endoscopic resection in the esophagus

    NARCIS (Netherlands)

    van Vilsteren, Frederike G. I.; Pouw, Roos E.; Herrero, Lorenza Alvarez; Bisschops, Raf; Houben, Martin; Peters, Frans T. M.; Schenk, B. E.; Weusten, Bas L. A. M.; Schoon, Erik J.; Bergman, Jacques J. G. H. M.

    Background: Endoscopic resection is the cornerstone of endoscopic management of esophageal early neoplasia. However, endoscopic resection is a complex technique requiring knowledge and expertise. Our aims were to identify the most important learning points in performing endoscopic resection in a

  5. [Laparoscopic liver resection: lessons learned after 132 resections].

    Science.gov (United States)

    Robles Campos, Ricardo; Marín Hernández, Caridad; Lopez-Conesa, Asunción; Olivares Ripoll, Vicente; Paredes Quiles, Miriam; Parrilla Paricio, Pascual

    2013-10-01

    After 20 years of experience in laparoscopic liver surgery there is still no clear definition of the best approach (totally laparoscopic [TLS] or hand-assisted [HAS]), the indications for surgery, position, instrumentation, immediate and long-term postoperative results, etc. To report our experience in laparoscopic liver resections (LLRs). Over a period of 10 years we performed 132 LLRs in 129 patients: 112 malignant tumours (90 hepatic metastases; 22 primary malignant tumours) and 20 benign lesions (18 benign tumours; 2 hydatid cysts). Twenty-eight cases received TLS and 104 had HAS. 6 right hepatectomies (2 as the second stage of a two-stage liver resection); 6 left hepatectomies; 9 resections of 3 segments; 42 resections of 2 segments; 64 resections of one segment; and 5 cases of local resections. There was no perioperative mortality, and morbidity was 3%. With TLS the resection was completed in 23/28 cases, whereas with HAS it was completed in all 104 cases. Transfusion: 4,5%; operating time: 150min; and mean length of stay: 3,5 days. The 1-, 3- and 5-year survival rates for the primary malignant tumours were 100, 86 and 62%, and for colorectal metastases 92, 82 and 52%, respectively. LLR via both TLS and HAS in selected cases are similar to the results of open surgery (similar 5-year morbidity, mortality and survival rates) but with the advantages of minimally invasive surgery. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  6. Innovative Tactic in Submandibular Salivary Gland Partial Resection

    Directory of Open Access Journals (Sweden)

    André Auersvald, MD, MSc

    2014-12-01

    Full Text Available Summary: Adequate neck contour is one of the goals in facial rejuvenation. In some patients, treating the submandibular salivary gland (SMSG ensures a satisfying result. Hematoma, sialoma, and paralysis of the depressors of the lower lip may occur when the deep neck is approached. The objective of this work is to present a new tactic to prevent the aforementioned complications. Two hundred forty consecutive neck lift patients with partial resection of the SMSG were studied. The tactic consisted of placing sutures to facilitate the retraction of the platysma muscle and the accompanying marginal mandibular and cervical branches of the facial nerve during the resection of the SMSG. It also included stitches that bring the platysma muscle in contact with the remaining SMSG, sealing the dissected area. The first 25 (control subjects did not undergo the tactic; the remaining 215 (study group did. The occurrence of paralysis of the depressors of the lower lip and of hematoma and sialoma originating from the SMSG resection was observed. When comparing the control group with the study group, the rates of hematoma (8% vs 0% and sialoma (24% vs 0% were significantly higher in the former. Paralysis of the depressors of the lower lip also had a higher rate in the control group (4% vs 0.9% although this difference was not statistically significant. The surgical tactic described is efficient in preventing the occurrence of hematoma, sialoma, and paralysis of the depressors of the lower lip in neck lift with partial resection of the SMSG.

  7. Comparative analysis of the pressure profilometry of vesicocutaneous continent catheterizable conduits between patients with and without rectus abdominis neosphincter (Yachia principle).

    Science.gov (United States)

    Rondon, Atila; Leslie, Bruno; Arcuri, Leonardo Javier; Ortiz, Valdemar; Macedo, Antonio

    2015-09-01

    To assess whether crossing rectus abdominis muscle strips, as proposed by Yachia, would change urinary catheterizable conduit's pressure profilometry, in static and dynamic conditions. Non-randomized selection of 20 continent patients that underwent Macedo's ileum-based reservoir, 10 including Yachia's technique (Study Group) and 10 without this mechanism of continence (Control Group). Demographics and cystometric data were assessed. Conduit's pressure profilometry was obtained by infusing saline through a multichannel catheter, at rest and during Valsalva maneuver. We assessed the pressure: (a) in the bladder; (b) in conduit's proximal segment; and (c) in conduit's distal segment, which is presumably the abdominal wall and crossed muscle strips site. Mean age at surgery was 6.1 years in the Control Group and 7.7 years in the Study Group. There was no statistically significant difference between groups regarding maximum cystometric bladder capacity and leakage point pressure. At rest, the pressure profilometry showed similar results between groups in all segments analyzed. During Valsalva maneuver, pressure profilometry showed similar results between groups in bladder and conduit's proximal segment pressure. In this condition, conduit's distal segment pressure in the Study Group (Mean = 72.9 and Peak = 128.7 cmH2 O) was significantly greater (P continence. © 2014 Wiley Periodicals, Inc.

  8. Unilateral blindness with third cranial nerve palsy and abnormal enhancement of extraocular muscles on magnetic resonance imaging of orbit after the ingestion of methanol.

    Science.gov (United States)

    Chung, Tae Nyoung; Kim, Sun Wook; Park, Yoo Seok; Park, Incheol

    2010-05-01

    Methanol is generally known to cause visual impairment and various systemic manifestations. There are a few reported specific findings for methanol intoxication on magnetic resonance imaging (MRI) of the brain. A case is reported of unilateral blindness with third cranial nerve palsy oculus sinister (OS) after the ingestion of methanol. Unilateral damage of the retina and optic nerve were confirmed by fundoscopy, flourescein angiography, visual evoked potential and electroretinogram. The optic nerve and extraocular muscles (superior rectus, medial rectus, inferior rectus and inferior oblique muscle) were enhanced by gadolinium-DTPA on MRI of the orbit. This is the first case report of permanent monocular blindness with confirmed unilateral damage of the retina and optic nerve, combined with third cranial nerve palsy after methanol ingestion.

  9. Predictive images of postoperative levator resection outcome using image processing software

    OpenAIRE

    Mawatari, Yuki; Fukushima, Mikiko

    2016-01-01

    Yuki Mawatari,1 Mikiko Fukushima2 1Igo Ophthalmic Clinic, Kagoshima, 2Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Chuo-ku, Kumamoto, Japan Purpose: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection.Methods: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller’s muscle complex (levator resection). P...

  10. Muscle force output and electromyographic activity in squats with various unstable surfaces.

    Science.gov (United States)

    Saeterbakken, Atle H; Fimland, Marius S

    2013-01-01

    The purpose of the study was to compare force output and muscle activity of leg and trunk muscles in isometric squats executed on stable surface (i.e., floor), power board, BOSU ball, and balance cone. Fifteen healthy men (23.3 ± 2.7 years, mass: 80.5 ± 8.5 kg, height: 1.81 ± 0.09 m) volunteered. The force output and electromyographic (EMG) activities of the rectus femoris, vastus medialis, vastus lateralis, biceps femoris, soleus, rectus abdominis, oblique external, and erector spinae were assessed. The order of the surfaces was randomized. One familiarization session was executed before the experimental test. Compared with stable surface (749 ± 222 N), the force output using power board was similar (-7%, p = 0.320) but lower for BOSU ball (-19%, p = 0.003) and balance cone (-24%, p ≤ 0.001). The force output using BOSU ball and balance cone was approximately 13% (p = 0.037) and approximately 18% (p = 0.001) less than the power board. There were similar EMG activities between the surfaces in all muscles except for rectus femoris, in which stable squat provided greater EMG activity than did the other exercises (p = 0.004-0.030). Lower EMG activity was observed in the rectus femoris using balance cone compared with the BOSU ball (p = 0.030). In conclusion, increasing the instability of the surface during maximum effort isometric squats usually maintains the muscle activity of lower-limb and superficial trunk muscles although the force output is reduced. This suggests that unstable surfaces in the squat may be beneficial in rehabilitation and as a part of periodized training programs, because similar muscle activity can be achieved with reduced loads.

  11. [Robot-assisted liver resection].

    Science.gov (United States)

    Aselmann, H; Möller, T; Kersebaum, J-N; Egberts, J H; Croner, R; Brunner, M; Grützmann, R; Becker, T

    2017-06-01

    Robotic liver resection can overcome some of the limitations of laparoscopic liver surgery; therefore, it is a promising tool to increase the proportion of minimally invasive liver resections. The present article gives an overview of the current literature. Furthermore, the results of a nationwide survey on robotic liver surgery among hospitals in Germany with a DaVinci system used in general visceral surgery and the perioperative results of two German robotic centers are presented.

  12. Endoscopic Transsphenoidal Resection of Craniopharyngioma.

    Science.gov (United States)

    Liew, Kong Yew; Narayanan, Prepageran; Waran, Vicknes

    2018-02-01

    Objectives  To demonstrate, step-by-step, the technique and efficacy of endoscopic transsphenoidal approach in resection of a suprasellar craniopharyngioma. Design  The video shows a step-by-step approach to the resection, covering the exposure, access, resection, and confirmation of resection and reconstruction. Setting  The surgery was performed in the University of Malaya Medical Centre, a tertiary referral center in the capital of Malaysia. Participants  Surgery was performed jointly by Professor Prepageran from the department of otorhinolaryngology and Professor Vicknes Waran from the division of neurosurgery. Both surgeons are from the University of Malaya. Video compilation, editing, and voice narration was done by Dr. Kong Yew Liew. Main Outcome Measures  Completeness of resection and avoidance of intra- and postoperative complications. Results  Based on intraoperative views and MRI findings, the tumor was completely resected with the patient suffering only transient diabetes insipidus. Conclusion  Central suprasellar tumors can be removed completely via an endoscopic transsphenoidal approach with minimal morbidity to the patient. The link to the video can be found at: https://youtu.be/ZNIHfk12cYg .

  13. Spontaneous Rectus Sheath Hematoma in the Elderly: An Unusual Case and Update on Proper Management

    Directory of Open Access Journals (Sweden)

    George Galyfos

    2014-01-01

    Full Text Available Spontaneous rectus sheath hematoma (SRSH is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient’s obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated.

  14. Flap Lymphedema after Successful Reconstruction of the Chronic Inguinal Wound with a Vertical Rectus Abdominis Flap (VRAM

    Directory of Open Access Journals (Sweden)

    Yalcin Kulahci

    2012-07-01

    Full Text Available The reconstruction of extensive and complex wounds represents a challenging problem for reconstructive surgeon. The reconstructive options to provide cover-age following debridment of these complicated wounds are local, distant flaps, or freetissue transfer. Vertical rectus abdominis flaps have been used succes-sully to repair defects in the groin, hip, perineal, trunk, and breast regions. We encountered flap lymphedema after successful reconstruction of the chronic in-guinal wound with a vertical rectus abdominis (VRAM flap. As far as were able to ascertain, there is no report in the literature related to flap lymphedema.

  15. Muscle sonography in six patients with hereditary inclusion body myopathy

    International Nuclear Information System (INIS)

    Adler, Ronald S.; Garolfalo, Giovanna; Paget, Stephen; Kagen, Lawrence

    2008-01-01

    To evaluate the morphological changes of muscle with sonography in six patients affected by hereditary inclusion body myopathy (HIBM). We studied a group of six Persian Jews diagnosed with HIBM. All were homozygous for the GNE mutation M712T. Ultrasonographic examinations of the quadriceps femoris and hamstring muscle groups were performed. A follow-up ultrasound examination was performed, after an interval of 3 years, in four of these patients. Muscles were assessed subjectively as to echogenicity, determined by gray-scale assessment, and loss of normal muscle morphology. Power Doppler sonography (PDS) was used to assess vascularity. A sonographic finding of central atrophy and peripheral sparing resulting in a target-like appearance was noted in the hamstring compartment of all six patients. The quadriceps compartment also showed involvement of the rectus femoris of all patients, which, in some cases, was the only muscle involved in the quadriceps. Vascularity was markedly reduced in the affected areas, with blood flow demonstrated in the peripherally spared areas. The severity of atrophy increased with disease duration. In this case series, we describe a new sonographic finding as well as document progression of HIBM disease, which has generally been described as quadriceps sparing. The myopathic target lesion, as well as isolated rectus femoris atrophy, may provide a useful adjunct to disease diagnosis. (orig.)

  16. Muscle electrical activity during exercises with and without load executed on dry land and in an aquatic environment

    Directory of Open Access Journals (Sweden)

    Indira Nayra Paz Santos

    Full Text Available Introduction Muscle activity in the aquatic environment was investigated using electromyographic analyses. The physical properties of water and the resistance used may influence the response of the muscle during exercise. The objective of this study was to evaluate the electrical activity in water and on the floor during flexion and knee extension exercises with and without load and aimed at understanding the muscular response while performing resistance exercises in water. Methods The sample consisted of 14 volunteers between 18 and 35 years old who were subjected to active exercises involving knee flexion and extension with and without load on the floor and in water. Electromyography was performed during the movement. Results A significant increase was found in the electrical activity of the rectus femoris muscle during exercises on the floor. The biceps femoris muscle showed increased electromyographic activity when resistance was used. A significant increase was found in the electrical activity of the rectus femoris muscle compared with exercises with and without load and the moment of rest in immersion. The electrical activity of the rectus and biceps femoris muscles was reduced in exercises with load and without load in a therapy pool compared with on the floor. Conclusion There was a reduction of the electromyographic activity in the aquatic environment compared with that on the ground, which could be attributed to the effects from hot water. Therefore, it is believed that resistance exercises can be performed early in a therapy pool, which will facilitate the prevention and treatment of musculoskeletal disorders.

  17. Decrease in pulmonary function and oxygenation after lung resection.

    Science.gov (United States)

    Brocki, Barbara Cristina; Westerdahl, Elisabeth; Langer, Daniel; Souza, Domingos S R; Andreasen, Jan Jesper

    2018-01-01

    Respiratory deficits are common following curative intent lung cancer surgery and may reduce the patient's ability to be physically active. We evaluated the influence of surgery on pulmonary function, respiratory muscle strength and physical performance after lung resection. Pulmonary function, respiratory muscle strength (maximal inspiratory/expiratory pressure) and 6-min walk test (6MWT) were assessed pre-operatively, 2 weeks post-operatively and 6 months post-operatively in 80 patients (age 68±9 years). Video-assisted thoracoscopic surgery was performed in 58% of cases. Two weeks post-operatively, we found a significant decline in pulmonary function (forced vital capacity -0.6±0.6 L and forced expiratory volume in 1 s -0.43±0.4 L; both p<0.0001), 6MWT (-37.6±74.8 m; p<0.0001) and oxygenation (-2.9±4.7 units; p<0.001), while maximal inspiratory and maximal expiratory pressure were unaffected. At 6 months post-operatively, pulmonary function and oxygenation remained significantly decreased (p<0.001), whereas 6MWT was recovered. We conclude that lung resection has a significant short- and long-term impact on pulmonary function and oxygenation, but not on respiratory muscle strength. Future research should focus on mechanisms negatively influencing post-operative pulmonary function other than impaired respiratory muscle strength.

  18. Expression of Dihydropyridine and Ryanodine Receptors in Type IIA Fibers of Rat Skeletal Muscle

    International Nuclear Information System (INIS)

    Anttila, Katja; Mänttäri, Satu; Järvilehto, Matti

    2007-01-01

    In this study, the fiber type specificity of dihydropyridine receptors (DHPRs) and ryanodine receptors (RyRs) in different rat limb muscles was investigated. Western blot and histochemical analyses provided for the first time evidence that the expression of both receptors correlates to a specific myosin heavy chain (MHC) composition. We observed a significant (p=0.01) correlation between DHP as well as Ry receptor density and the expression of MHC IIa (correlation factor r=0.674 and r=0.645, respectively) in one slow-twitch, postural muscle (m. soleus), one mixed, fast-twitch muscle (m. gastrocnemius) and two fast-twitch muscles (m. rectus femoris, m. extensor digitorum longus). The highest DHP and Ry receptor density was found in the white part of m. rectus femoris (0.058±0.0060 and 0.057±0.0158 ODu, respectively). As expected, the highest relative percentage of MHC IIa was also found in the white part of m. rectus femoris (70.0±7.77%). Furthermore, histochemical experiments revealed that the IIA fibers stained most strongly for the fluorophore-conjugated receptor blockers. Our data clearly suggest that the expression of DHPRs and RyRs follows a fiber type-specific pattern, indicating an important role for these proteins in the maintenance of an effective Ca 2+ cycle in the fast contracting fiber type IIA

  19. Surgical technique for en bloc transurethral resection of bladder tumour with a Hybrid Knife(®).

    Science.gov (United States)

    Islas-García, J J O; Campos-Salcedo, J G; López-Benjume, B I; Torres-Gómez, J J; Aguilar-Colmenero, J; Martínez-Alonso, I A; Gil-Villa, S A

    2016-05-01

    Bladder cancer is the second most common malignancy of the urinary tract and the 9th worldwide. Latin American has an incidence of 5.6 per 100,000 inhabitants per year. Seventy-five percent of newly diagnosed cases are nonmuscle invasive bladder cancer, and 25% of cases present as muscle invasive. The mainstay of treatment for nonmuscle invasive bladder cancer is loop transurethral resection. In 2013, the group led by Dr Mundhenk of the University Hospital of Tübingen, Germany, was the first to describe the Hybrid Knife(®) equipment for performing en bloc bladder tumour resection, with favourable functional and oncological results. To describe the surgical technique of en bloc bladder tumour resection with a Hybrid Knife(®) as an alternative treatment for nonmuscle invasive bladder tumours. A male patient was diagnosed by urotomography and urethrocystoscopy with a bladder tumour measuring 2×1cm on the floor. En bloc transurethral resection of the bladder tumour was performed with a Hybrid Knife(®). Surgery was performed for 35min, with 70 watts for cutting and 50 watts for coagulation, resecting and evacuating en bloc the bladder tumour, which macroscopically included the muscle layer of the bladder. There were no complications. The technique of en bloc bladder tumour resection with Hybrid Knife(®) is an effective alternative to bipolar loop transurethral resection. Resection with a Hybrid Knife(®) is a procedure with little bleeding and good surgical vision and minimises the risk of bladder perforation and tumour implants. The procedure facilitates determining the positivity of the neoplastic process, vascular infiltration and bladder muscle invasion in the histopathology study. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. [Effects of surgery on muscles on clinical and radiographic findings in the hip joint region in cerebral palsy patients].

    Science.gov (United States)

    Schejbalová, A; Havlas, V

    2008-10-01

    PURPOSE OF THE STUDY Isolated or combined surgical procedures on muscles around the hip joint are currently indicated by many authors. In cerebral palsy patients they are regarded as essential intervention. MATERIAL In the years 2005-2007, surgery in the hip joint region was essential for 150 children between 3 and 18 years of age. At the time of surgery, the patients' locomotion ranged from stage 1 to stage 7 of the Vojta system. METHODS The outcome was evaluated by clinical and radiographic examination at 2 and 6 months post-operatively and hip migration percentage and Wiberg's CE angle were measured. RESULTS The best clinical and radiographic outcomes were achieved in children younger than 6 years of age. On the other hand, isolated transfer of the distal rectus femoris muscle significantly affected pelvis anteflexion in adolescent patients. The most marked decrease in migration percentage was found after adductor tenotomy combined with surgery on the iliopsoas muscle (55.6 %) or when the two procedures were combined with distal rectus femoris transfer. DISCUSSION Combined surigical procedures, i.e., adductor tenotomy, surgery on the iliopsoas muscle or rectus femoris muscle and medial hamstrings, with fixation using an abduction modified Atlanta brace, are effective in patients with marked lateral hip migration who are younger that 6 years. Isolated adductor tenotomy and distal transfer of the rectus femoris muscle markedly improve standing position in walking patients. CONCLUSION An appropriate combination of surgical procedures on muscles in the hip region and on medial hamstrings can significantly improve the patient's locomotion and, if lateral migration is present, help to avoid surgery on bones.

  1. The neuromechanical functional contractile properties of the thigh muscles measured using tensiomyography in male athletes and non-athletes

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    Toskić Lazar

    2016-01-01

    Full Text Available Involuntary neuromechanical muscle contractile properties, especially of the extensor muscles and knee joint flexors as the largest muscle groups of the caudal part of the body, play an important role in both everyday movement and sport. Based on these data we can obtain important information on the functional properties of muscles. The basic means of evaluation of the functional involuntary neuromechanical muscles contractile properties is the non-invasive tensiomyographic method (TMG. The aim of this study was to determine the differences between the involuntary neuromechanical contractile properties of the thigh muscles measured using the TMG method on a sample of male athletes and non-athletes. The sample of participants was made up of 17 athletes and 10 non-athletes. By applying the multivariate analysis of variance (MANOVA and the t-test, we achieved results which indicate that of the overall 30 variables, a difference was determined among 13 of them. Most of the differences were determined for the extensor muscles of the right knee, especially of the rectus femoris muscle. It was also shown that in addition to the main knee joint extensor muscle (rectus femoris the main knee joint flexor muscle (biceps femoris also takes part in the definition of the difference between athletes and non-athletes. The results have shown that the following variables: contraction time (Tc and delay contraction time (Td are the functional parameters for which the highest difference between athletes and non-athletes were determined (from t = -2.284, p < 0.05 for the vastus lateralis of the right leg to t = -4.018, p < 0.01 for the rectus femoris of the left leg. These results have shown that it is possible to determine the differences in the functional involuntary neuromechanical contractile properties of the thigh muscles among trained and untrained individuals using the tensiomyographic method, but at the same time indicated that these differences were very

  2. Ultrasound-guided rectus sheath and transversus abdominis plane blocks for perioperative analgesia in upper abdominal surgery: A randomized controlled study

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    Khaled Abdelsalam

    2016-01-01

    Full Text Available Background: Regional anesthetic techniques can be used to alleviate postoperative pain in patients undergoing major upper abdominal surgery. Our aim was to evaluate the efficacy of bilateral ultrasound (US-guided rectus sheath (RS and transversus abdominis plane (TAP blocks for better perioperative analgesia. Patients and Methods: It is a prospective, observer-blinded, randomized clinical study. 40 eligible patients undergoing elective liver resection or Whipple procedure were included. All patients received a standardized anesthetic technique. Group 1 (n = 20 received preincisional US-guided bilateral RS and TAP blocks using 20 ml volume of bupivacaine 0.25% for each, and group 2 (n = 20 received local wound infiltration at end of surgery with 40 ml of bupivacaine 0.25%. A standardized postoperative analgesic regimen composed of intravenous paracetamol and a morphine patient-controlled analgesia (PCA. The use of intraoperative fentanyl and recovery room morphine boluses, PCA-administered morphine, pain scores as well as number of patients′ experienced postoperative nausea and vomiting in the ward at 6 and 24 h were recorded. Results: Group 1 patients received a significantly lower cumulative intraoperative fentanyl, significantly lesser boluses of morphine in postanesthesia care unit, as well, significantly lower cumulative 24 h postoperative morphine dosage than the group 2 patients. Pain visual analog scale scores were significantly lower at both 6 and 24 h postoperatively in TAP group when compared with the no-TAP group. There were no complications related to the TAP block procedures. No signs or symptoms of local anesthetic systemic toxicity were detected. Conclusion: The combination of bilateral US-guided RS and TAP blocks provides excellent perioperative analgesia for major upper abdominal surgery.

  3. Parenteral Nutrition in Liver Resection

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    Carlo Chiarla

    2012-01-01

    Full Text Available Albeit a very large number of experiments have assessed the impact of various substrates on liver regeneration after partial hepatectomy, a limited number of clinical studies have evaluated artificial nutrition in liver resection patients. This is a peculiar topic because many patients do not need artificial nutrition, while several patients need it because of malnutrition and/or prolonged inability to feeding caused by complications. The optimal nutritional regimen to support liver regeneration, within other postoperative problems or complications, is not yet exactly defined. This short review addresses relevant aspects and potential developments in the issue of postoperative parenteral nutrition after liver resection.

  4. Lower extremity muscle functions during full squats.

    Science.gov (United States)

    Robertson, D G E; Wilson, Jean-Marie J; St Pierre, Taunya A

    2008-11-01

    The purpose of this research was to determine the functions of the gluteus maximus, biceps femoris, semitendinosus, rectus femoris, vastus lateralis, soleus, gastrocnemius, and tibialis anterior muscles about their associated joints during full (deep-knee) squats. Muscle function was determined from joint kinematics, inverse dynamics, electromyography, and muscle length changes. The subjects were six experienced, male weight lifters. Analyses revealed that the prime movers during ascent were the monoarticular gluteus maximus and vasti muscles (as exemplified by vastus lateralis) and to a lesser extent the soleus muscles. The biarticular muscles functioned mainly as stabilizers of the ankle, knee, and hip joints by working eccentrically to control descent or transferring energy among the segments during scent. During the ascent phase, the hip extensor moments of force produced the largest powers followed by the ankle plantar flexors and then the knee extensors. The hip and knee extensors provided the initial bursts of power during ascent with the ankle extensors and especially a second burst from the hip extensors adding power during the latter half of the ascent.

  5. Oxidative proteome alterations during skeletal muscle ageing

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    Sofia Lourenço dos Santos

    2015-08-01

    Full Text Available Sarcopenia corresponds to the degenerative loss of skeletal muscle mass, quality, and strength associated with ageing and leads to a progressive impairment of mobility and quality of life. However, the cellular and molecular mechanisms involved in this process are not completely understood. A hallmark of cellular and tissular ageing is the accumulation of oxidatively modified (carbonylated proteins, leading to a decreased quality of the cellular proteome that could directly impact on normal cellular functions. Although increased oxidative stress has been reported during skeletal muscle ageing, the oxidized protein targets, also referred as to the ‘oxi-proteome’ or ‘carbonylome’, have not been characterized yet. To better understand the mechanisms by which these damaged proteins build up and potentially affect muscle function, proteins targeted by these modifications have been identified in human rectus abdominis muscle obtained from young and old healthy donors using a bi-dimensional gel electrophoresis-based proteomic approach coupled with immunodetection of carbonylated proteins. Among evidenced protein spots, 17 were found as increased carbonylated in biopsies from old donors comparing to young counterparts. These proteins are involved in key cellular functions such as cellular morphology and transport, muscle contraction and energy metabolism. Importantly, impairment of these pathways has been described in skeletal muscle during ageing. Functional decline of these proteins due to irreversible oxidation may therefore impact directly on the above-mentioned pathways, hence contributing to the generation of the sarcopenic phenotype.

  6. Sudden shrinkage of free rectus abdominis musculocutaneous flap 15 years after maxilla reconstruction

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    Yasushi Mochizuki

    2018-03-01

    Full Text Available A 60-year-old male displayed sudden shrinkage of a left free rectus abdominis musculocutaneous flap, which had been grafted to his left maxilla 15 years previously. No post-reconstructive irradiation had been performed, and no late occlusion of the vascular anastomosis, local infection, recurrence of the maxillary cancer, or body weight loss was observed. However, the shrinkage amounted to approximately 50%. This is considerably more than previously reported cases of shrinkage of various free flaps, which ranged between 10% and 25%. The resultant depression was successfully augmented with a right free deep inferior epigastric artery perforator flap. The residual fat volume of the previously grafted shrunken flap was revealed to be compatible with that of the newly harvested contralateral perforator flap. Thus, the volume of the previously grafted flap may reflect the status of the intact contralateral donor site, although the mechanism of sudden flap shrinkage is unclear.

  7. Unstable gait due to spasticity of the rectus femoris: gait analysis and motor nerve block.

    Science.gov (United States)

    Gross, R; Leboeuf, F; Rémy-Néris, O; Perrouin-Verbe, B

    2012-12-01

    We present the case of a 54 year-old man presenting with a right Brown-Séquard plus syndrome (BSPS) after a traumatic cervical spinal cord injury. After being operated on with selective tibial neurotomy and triceps surae lengthening because of a right spastic equinus foot, he developed a gait disorder at high speed. The patient complained about an instability of the right knee. Observational gait analysis exhibited an oscillating, flexion/extension motion of the right knee during stance, which was confirmed by gait analysis. Dynamic electromyographic recordings exhibited a clonus of the right rectus femoris (RF) during stance. The spastic activity of the RF and the abnormal knee motion totally reversed after a motor nerve block of the RF, as well as after botulinum toxin type A injection into the RF. We emphasize that complex, spastic gait disorders can benefit from a comprehensive assessment including gait analysis and nerve blocks. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  8. Idiopathic masseter muscle hypertrophy.

    Science.gov (United States)

    Kebede, Biruktawit; Megersa, Shimalis

    2011-11-01

    Benign Masseteric Hypertrophy is a relatively uncommon condition that can occur unilaterally or bilaterally. Pain may be a symptom, but most frequently a clinician is consulted for cosmetic reasons. In some cases prominent Exostoses at the angle of the mandible are noted. Although it is tempting to point to Malocclusion, Bruxism, clenching, or Temporomandibular joint disorders, the etiology in the majority of cases is unclear. Diagnosis is based on awareness of the condition, clinical and radiographic findings, and exclusion of more serious Pathology such as Benign and Malignant Parotid Disease, Rhabdomyoma, and Lymphangioma. Treatment usually involves resection of a portion of the Masseter muscle with or without the underlying bone.

  9. Functional and morphological variety in trunk muscles of Urodela.

    Science.gov (United States)

    Omura, Ayano; Anzai, Wataru; Endo, Hideki

    2014-03-01

    Trunk musculature in Urodela species varies by habitat. In this study, trunk musculature was examined in five species of adult salamanders representing three different habitats: aquatic species, Amphiuma tridactylum and Necturus maculosus; semi-aquatic species, Cynops pyrrhogaster; terrestrial species, Hynobius nigrescens and Ambystoma tigrinum. More terrestrial species have heavier dorsal and ventral trunk muscles than more aquatic forms. By contrast, the lateral hypaxial musculature was stronger in more aquatic species. The number of layers of lateral hypaxial musculature varied among Urodela species and did not clearly correlate with their habitats. The M. rectus abdominis was separated from the lateral hypaxial musculature in both terrestrial and semi-aquatic species. In aquatic species, M. rectus abdominis was not separated from lateral hypaxial musculature. Lateral hypaxial musculature differed in thickness among species and was relatively thinner in terrestrial species. In more terrestrial species, dorsal muscles may be used for stabilization and ventral flexing against gravity. Ventral muscle may be used in preventing dorsally concave curvature of the trunk by dorsal muscles and by weight. The lengthy trunk supported by limbs needs muscular forces along the ventral contour line in more terrestrial species. And, the locomotion on well-developed limbs seems to lead to a decrease of the lateral hypaxial musculature.

  10. Laparoscopic resection of hilar cholangiocarcinoma.

    Science.gov (United States)

    Lee, Woohyung; Han, Ho-Seong; Yoon, Yoo-Seok; Cho, Jai Young; Choi, YoungRok; Shin, Hong Kyung; Jang, Jae Yool; Choi, Hanlim

    2015-10-01

    Laparoscopic resection of hilar cholangiocarcinoma is technically challenging because it involves complicated laparoscopic procedures that include laparoscopic hepatoduodenal lymphadenectomy, hemihepatectomy with caudate lobectomy, and hepaticojejunostomy. There are currently very few reports describing this type of surgery. Between August 2014 and December 2014, 5 patients underwent total laparoscopic or laparoscopic-assisted surgery for hilar cholangiocarcinoma. Two patients with type I or II hilar cholangiocarcinoma underwent radical hilar resection. Three patients with type IIIa or IIIb cholangiocarcinoma underwent extended hemihepatectomy together with caudate lobectomy. The median (range) age, operation time, blood loss, and length of hospital stay were 63 years (43-76 years), 610 minutes (410-665 minutes), 650 mL (450-1,300 mL), and 12 days (9-21 days), respectively. Four patients had a negative margin, but 1 patient was diagnosed with high-grade dysplasia on the proximal resection margin. The median tumor size was 3.0 cm. One patient experienced postoperative biliary leakage, which resolved spontaneously. Laparoscopic resection is a feasible surgical approach in selected patients with hilar cholangiocarcinoma.

  11. Awake craniotomy for tumor resection.

    Science.gov (United States)

    Attari, Mohammadali; Salimi, Sohrab

    2013-01-01

    Surgical treatment of brain tumors, especially those located in the eloquent areas such as anterior temporal, frontal lobes, language, memory areas, and near the motor cortex causes high risk of eloquent impairment. Awake craniotomy displays major rule for maximum resection of the tumor with minimum functional impairment of the Central Nervous System. These case reports discuss the use of awake craniotomy during the brain surgery in Alzahra Hospital, Isfahan, Iran. A 56-year-old woman with left-sided body hypoesthesia since last 3 months and a 25-year-old with severe headache of 1 month duration were operated under craniotomy for brain tumors resection. An awake craniotomy was planned to allow maximum tumor intraoperative testing for resection and neurologic morbidity avoidance. The method of anesthesia should offer sufficient analgesia, hemodynamic stability, sedation, respiratory function, and also awake and cooperative patient for different neurological test. Airway management is the most important part of anesthesia during awake craniotomy. Tumor surgery with awake craniotomy is a safe technique that allows maximal resection of lesions in close relationship to eloquent cortex and has a low risk of neurological deficit.

  12. Awake craniotomy for tumor resection

    Directory of Open Access Journals (Sweden)

    Mohammadali Attari

    2013-01-01

    Full Text Available Surgical treatment of brain tumors, especially those located in the eloquent areas such as anterior temporal, frontal lobes, language, memory areas, and near the motor cortex causes high risk of eloquent impairment. Awake craniotomy displays major rule for maximum resection of the tumor with minimum functional impairment of the Central Nervous System. These case reports discuss the use of awake craniotomy during the brain surgery in Alzahra Hospital, Isfahan, Iran. A 56-year-old woman with left-sided body hypoesthesia since last 3 months and a 25-year-old with severe headache of 1 month duration were operated under craniotomy for brain tumors resection. An awake craniotomy was planned to allow maximum tumor intraoperative testing for resection and neurologic morbidity avoidance. The method of anesthesia should offer sufficient analgesia, hemodynamic stability, sedation, respiratory function, and also awake and cooperative patient for different neurological test. Airway management is the most important part of anesthesia during awake craniotomy. Tumor surgery with awake craniotomy is a safe technique that allows maximal resection of lesions in close relationship to eloquent cortex and has a low risk of neurological deficit.

  13. Muscle Deoxygenation Causes Muscle Fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  14. Laparoscopic resection for diverticular disease.

    Science.gov (United States)

    Bruce, C J; Coller, J A; Murray, J J; Schoetz, D J; Roberts, P L; Rusin, L C

    1996-10-01

    The role of laparoscopic surgery in treatment of patients with diverticulitis is unclear. A retrospective comparison of laparoscopic with conventional surgery for patients with chronic diverticulitis was performed to assess morbidity, recovery from surgery, and cost. Records of patients undergoing elective resection for uncomplicated diverticulitis from 1992 to 1994 at a single institution were reviewed. Laparoscopic resection involved complete intracorporeal dissection, bowel division, and anastomosis with extracorporeal placement of an anvil. Sigmoid and left colon resections were performed laparoscopically in 25 patients and by open technique in 17 patients by two independent operating teams. No significant differences existed in age, gender, weight, comorbidities, or operations performed. In the laparoscopic group, three operations were converted to open laparotomy (12 percent) because of unclear anatomy. Major complications occurred in two patients who underwent laparoscopic resection, both requiring laparotomy, and in one patient in the conventional surgery group who underwent computed tomographic-guided drainage of an abscess. Patients who underwent laparoscopic resection tolerated a regular diet sooner than patients who underwent conventional surgery (3.2 +/- 0.9 vs. 5.7 +/- 1.1 days; P < 0.001) and were discharged from the hospital earlier (4.2 +/- 1.1 vs. 6.8 +/- 1.1 days; P < 0.001). Overall costs were higher in the laparoscopic group than the open surgery group ($10,230 +/- 49.1 vs. $7,068 +/- 37.1; P < 0.001) because of a significantly longer total operating room time (397 +/- 9.1 vs. 115 +/- 5.1 min; P < 0.001). Follow-up studies with a mean of one year revealed two port site infections in the laparoscopic group and one wound infection in the open group. Of patients undergoing conventional resection, one patient experienced a postoperative bowel obstruction that was managed nonoperatively, and, in one patient, an incarcerated incisional hernia

  15. Muscle Cramps

    Science.gov (United States)

    ... Talk to your provider about the risks and benefits of medicines. How can I prevent muscle cramps? To prevent muscle cramps, you can Stretch your muscles, especially before exercising. If you often get leg cramps at night, ...

  16. Electromyographic assessment of trunk and shoulder muscles during a Pilates pull-up exercise

    Directory of Open Access Journals (Sweden)

    Isabel C.N. Sacco

    2014-06-01

    Full Text Available This study compares surface electromyographic activity of the internal oblique, rectus abdominis, multifidus, iliocostalis, anterior deltoids during the pull-up on a lower and on a higher difficulty level. We assessed nine adults with previous experience in Pilates. The root mean square (RMS values were normalized by maximum isometric contraction for each participant. During the ascent phase, the low spring position showed a significantly higher RMS than the high spring position of 8.9% for deltoid, 17.2% for internal oblique, 22.3% for rectus abdominis, 4.1% for iliocostalis, and 5.6% for multifidus, and in the descent phase, the RMS in the lower spring exceeded significantly the high spring position in 1.6% for the deltoid, 10% for internal oblique, 31.4% for rectus abdominis and 11.4% for iliocostalis. There was no predominance of abdominal muscles over the shoulder muscle in any spring position. The pull-up exercise can be a useful choice for the core and anterior deltoid muscles strengthening.

  17. Augmented reality in bone tumour resection

    Science.gov (United States)

    Park, Y. K.; Gupta, S.; Yoon, C.; Han, I.; Kim, H-S.; Choi, H.; Hong, J.

    2017-01-01

    Objectives We evaluated the accuracy of augmented reality (AR)-based navigation assistance through simulation of bone tumours in a pig femur model. Methods We developed an AR-based navigation system for bone tumour resection, which could be used on a tablet PC. To simulate a bone tumour in the pig femur, a cortical window was made in the diaphysis and bone cement was inserted. A total of 133 pig femurs were used and tumour resection was simulated with AR-assisted resection (164 resection in 82 femurs, half by an orthropaedic oncology expert and half by an orthopaedic resident) and resection with the conventional method (82 resection in 41 femurs). In the conventional group, resection was performed after measuring the distance from the edge of the condyle to the expected resection margin with a ruler as per routine clinical practice. Results The mean error of 164 resections in 82 femurs in the AR group was 1.71 mm (0 to 6). The mean error of 82 resections in 41 femurs in the conventional resection group was 2.64 mm (0 to 11) (p Augmented reality in bone tumour resection: An experimental study. Bone Joint Res 2017;6:137–143. PMID:28258117

  18. Push-back technique facilitates ultra-low anterior resection without nerve injury in total mesorectal excision for rectal cancer.

    Science.gov (United States)

    Inoue, Yasuhiro; Hiro, Junichiro; Toiyama, Yuji; Tanaka, Koji; Uchida, Keiichi; Miki, Chikao; Kusunoki, Masato

    2011-01-01

    To describe our push-back approach to ultra-low anterior resection using the concept of the mucosal stump. We mobilize the rectum using an abdominal approach, and perform mucosal cutting circumferentially at the dentate line. The mucosal stump is closed, and the internal sphincteric muscle resected partially or totally according to tumor location. Perianal dissection is performed along the medial plane of the external sphincteric muscles, and the hiatal ligament is dissected posteriorly. To resect the entire rectum, the closed rectal stump is pushed back to the abdominal cavity using composed gauze. This prevents injury to the autonomic nerve. We performed colonic J-pouch anal anastomosis using our mucosal stump approach in 58 patients with rectal cancer located push-back approach for internal sphincter resection produces satisfactory functional and oncological results in ultra-low anterior rectal cancer. Copyright © 2011 S. Karger AG, Basel.

  19. Trunk muscle recruitment patterns in simulated precrash events.

    Science.gov (United States)

    Ólafsdóttir, Jóna Marín; Fice, Jason B; Mang, Daniel W H; Brolin, Karin; Davidsson, Johan; Blouin, Jean-Sébastien; Siegmund, Gunter P

    2018-02-28

    To quantify trunk muscle activation levels during whole body accelerations that simulate precrash events in multiple directions and to identify recruitment patterns for the development of active human body models. Four subjects (1 female, 3 males) were accelerated at 0.55 g (net Δv = 4.0 m/s) in 8 directions while seated on a sled-mounted car seat to simulate a precrash pulse. Electromyographic (EMG) activity in 4 trunk muscles was measured using wire electrodes inserted into the left rectus abdominis, internal oblique, iliocostalis, and multifidus muscles at the L2-L3 level. Muscle activity evoked by the perturbations was normalized by each muscle's isometric maximum voluntary contraction (MVC) activity. Spatial tuning curves were plotted at 150, 300, and 600 ms after acceleration onset. EMG activity remained below 40% MVC for the three time points for most directions. At the 150- and 300 ms time points, the highest EMG amplitudes were observed during perturbations to the left (-90°) and left rearward (-135°). EMG activity diminished by 600 ms for the anterior muscles, but not for the posterior muscles. These preliminary results suggest that trunk muscle activity may be directionally tuned at the acceleration level tested here. Although data from more subjects are needed, these preliminary data support the development of modeled trunk muscle recruitment strategies in active human body models that predict occupant responses in precrash scenarios.

  20. Computed tomographic findings of skeletal muscles in amyotrophic lateral sclerosis (ALS)

    International Nuclear Information System (INIS)

    Takahashi, Ryosuke; Imai, Terukuni; Sadashima, Hiromichi; Matsumoto, Sadayuki; Yamamoto, Toru; Kusaka, Hirobumi; Yamasaki, Masahiro; Maya, Kiyomi; Tanabe, Masaya

    1989-01-01

    We evaluated the Computed Tomographic (CT) findings of skeletal muscles in 12 cases of amyotrophic lateral sclerosis (ALS), 1 case of spinal progressive muscular atrophy (SPMA), and 1 case of Kugelberg-Welander disease. CT examination was performed in the neck, shoulders, abdomen, pelvis, thighs, and lower legs, 15 muscles were selected for evaluation. The following muscles tended to be affected: m. transversospinalis (12 cases were abnormal), m. deltoideus (10), m. subscapularis (10), m. infraspinatus (10), mm. dorsi (12), hamstring muscles (14), m. tibialis anterior (14), and m. triceps surae (14). On the contrary, the following muscles tended to be preserved: m. sternocleidomastoideus (only 7 cases were abnormal), m. psoas major (7), m. gluteus maximus (7), m. rectus femoris (7), m. sartorius (7) and m. gracilis (6). The distribution of the muscles affected showed neither proximal nor distal dominancy. As the disease advanced, however, all the muscles became affected without any severity. CT findings of skeletal muscles in ALS were characterized by muscle atrophy and fat infiltration, which showed a patchy, linear, or moth-eaten appearance. In mildly affected cases, there was muscle atrophy without internal architectual changes. In moderately affected cases, muscle atrophy advanced and internal architectural changes (patchy, linear, and moth-eaten fat infiltration) became evident. In most advanced cases, every muscle showed a ragged appearance because of severe muscle atrophy and internal architectural changes. These findings were well distinguished from those of SPMA, which resembled the CT pattern of primary muscle diseases. (author)

  1. Computed tomographic findings of skeletal muscles in amyotrophic lateral sclerosis (ALS)

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Ryosuke; Imai, Terukuni; Sadashima, Hiromichi; Matsumoto, Sadayuki; Yamamoto, Toru; Kusaka, Hirobumi; Yamasaki, Masahiro; Maya, Kiyomi; Tanabe, Masaya (Kitano Hospital, Osaka (Japan))

    1989-04-01

    We evaluated the Computed Tomographic (CT) findings of skeletal muscles in 12 cases of amyotrophic lateral sclerosis (ALS), 1 case of spinal progressive muscular atrophy (SPMA), and 1 case of Kugelberg-Welander disease. CT examination was performed in the neck, shoulders, abdomen, pelvis, thighs, and lower legs, 15 muscles were selected for evaluation. The following muscles tended to be affected: m. transversospinalis (12 cases were abnormal), m. deltoideus (10), m. subscapularis (10), m. infraspinatus (10), mm. dorsi (12), hamstring muscles (14), m. tibialis anterior (14), and m. triceps surae (14). On the contrary, the following muscles tended to be preserved: m. sternocleidomastoideus (only 7 cases were abnormal), m. psoas major (7), m. gluteus maximus (7), m. rectus femoris (7), m. sartorius (7) and m. gracilis (6). The distribution of the muscles affected showed neither proximal nor distal dominancy. As the disease advanced, however, all the muscles became affected without any severity. CT findings of skeletal muscles in ALS were characterized by muscle atrophy and fat infiltration, which showed a patchy, linear, or moth-eaten appearance. In mildly affected cases, there was muscle atrophy without internal architectual changes. In moderately affected cases, muscle atrophy advanced and internal architectural changes (patchy, linear, and moth-eaten fat infiltration) became evident. In most advanced cases, every muscle showed a ragged appearance because of severe muscle atrophy and internal architectural changes. These findings were well distinguished from those of SPMA, which resembled the CT pattern of primary muscle diseases. (author).

  2. Pneumatic Muscles Actuated Lower-Limb Orthosis Model Verification with Actual Human Muscle Activation Patterns

    Directory of Open Access Journals (Sweden)

    Dzahir M.A.M

    2017-01-01

    Full Text Available A review study was conducted on existing lower-limb orthosis systems for rehabilitation which implemented pneumatic muscle type of actuators with the aim to clarify the current and on-going research in this field. The implementation of pneumatic artificial muscle will play an important role for the development of the advanced robotic system. In this research a derivation model for the antagonistic mono- and bi-articular muscles using pneumatic artificial muscles of a lower limb orthosis will be verified with actual human’s muscle activities models. A healthy and young male 29 years old subject with height 174cm and weight 68kg was used as a test subject. Two mono-articular muscles Vastus Medialis (VM and Vastus Lateralis (VL were selected to verify the mono-articular muscle models and muscle synergy between anterior muscles. Two biarticular muscles Rectus Femoris (RF and Bicep Femoris (BF were selected to verify the bi-articular muscle models and muscle co-contraction between anterior-posterior muscles. The test was carried out on a treadmill with a speed of 4.0 km/h, which approximately around 1.25 m/s for completing one cycle of walking motion. The data was collected for about one minute on a treadmill and 20 complete cycles of walking motion were successfully recorded. For the evaluations, the mathematical model obtained from the derivation and the actual human muscle activation patterns obtained using the surface electromyography (sEMG system were compared and analysed. The results shown that, high correlation values ranging from 0.83 up to 0.93 were obtained in between the derivation model and the actual human muscle’s model for both mono- and biarticular muscles. As a conclusion, based on the verification with the sEMG muscle activities data and its correlation values, the proposed derivation models of the antagonistic mono- and bi-articular muscles were suitable to simulate and controls the pneumatic muscles actuated lower limb

  3. Trunk Muscle EMG During Intermediate Pilates Mat Exercises in Beginner Healthy and Chronic Low Back Pain Individuals.

    Science.gov (United States)

    Pereira, Ivye L R; Queiroz, Bergson; Loss, Jefferson; Amorim, César; Sacco, Isabel C N

    2017-06-01

    The purpose of this study was to compare the electromyographic pattern of core muscles during intermediate Pilates mat exercises between healthy people and those with low back pain. We evaluated healthy participants (n = 19; mean ± standard deviation [SD]: age 28 ± 8 years, body mass 65 ± 10 kg, height 160.0 ± 9.1 cm) and a low back pain group (n = 13; mean ± SD: age 30 ± 9 years, body mass 67 ± 12 kg, height 170.0 ± 6.6 cm). Electromyographic analysis assessed the multifidus, external oblique, internal oblique, and rectus abdominis muscles during classical Pilates exercises (single leg stretch, criss-cross, and dead bug). We calculated the root mean square normalized by maximum voluntary contraction, and the time of peak activation was provided by a linear envelope and normalized by the total movement cycle. The criss-cross exercise presented the highest values of root mean square for trunk flexors (rectus abdominis and oblique) compared with the other exercises, followed by the single leg stretch and the dead bug, which had similar muscle activation. The single leg stretch presented more activation of the rectus abdominis and oblique, whereas the criss-cross and dead bug created more activation of the oblique compared with the multifidus and rectus. The Pilates exercises presented different muscle recruitment patterns, and allowed the activation of the lumbopelvic stabilizing muscles even in the first session for healthy individuals and those with chronic low back pain. Copyright © 2017. Published by Elsevier Inc.

  4. Assessment of muscle fatigue during biking.

    Science.gov (United States)

    Knaflitz, Marco; Molinari, Filippo

    2003-03-01

    The analysis of the surface myoelectric signal recorded while a muscle is performing a sustained contraction is a valuable tool for assessing the progression of localized fatigue. It is well known that the modifications of the spectral content of the myoelectric signal are mainly related to changes in the interstitial fluid pH, which, in turn, affect the membrane excitability of the active muscle fibers. This paper describes the effects of muscle fatigue on the surface myoelectric signal recorded from three thigh and leg muscles during biking, on a population consisting of 22 young healthy volunteers. The purpose of this study was to obtain normative data relative to an exercise protocol mild enough to be applicable, in the future, to pathological subjects as well. Each subject was asked to exercise 30 min on a cycloergometer at a constant velocity and against a constant torque. While subjects were biking, the surface myoelectric signal was recorded from the rectus femoris, the biceps femoris, and the gastrocnemius muscles. In this study, we considered two different aspects of muscle fatigue: first, the localized muscle fatigue as shown by the decrement of the instantaneous frequency of the myoelectric signal during the exercise; second, the modifications of the muscle ON-OFF timing, which could be explained as a strategy for increasing endurance by modifying the role of different muscles during the exercise. The first aspect was studied by obtaining the spectral characteristics of the signals by means of bilinear time-frequency transforms and by applying an original estimator of the instantaneous frequency of stochastic processes based on cross time-frequency transforms. Our results demonstrated that none of the subjects showed significant signs of localized muscle fatigue, since the decrement of the instantaneous frequency during the exercise was always lower than 5% of its initial value. Muscle ON-OFF timing was obtained by applying to the raw myoelectric signal

  5. [Robot-assisted pancreatic resection].

    Science.gov (United States)

    Müssle, B; Distler, M; Weitz, J; Welsch, T

    2017-06-01

    Although robot-assisted pancreatic surgery has been considered critically in the past, it is nowadays an established standard technique in some centers, for distal pancreatectomy and pancreatic head resection. Compared with the laparoscopic approach, the use of robot-assisted surgery seems to be advantageous for acquiring the skills for pancreatic, bile duct and vascular anastomoses during pancreatic head resection and total pancreatectomy. On the other hand, the use of the robot is associated with increased costs and only highly effective and professional robotic programs in centers for pancreatic surgery will achieve top surgical and oncological quality, acceptable operation times and a reduction in duration of hospital stay. Moreover, new technologies, such as intraoperative fluorescence guidance and augmented reality will define additional indications for robot-assisted pancreatic surgery.

  6. Enhanced recovery after esophageal resection.

    Science.gov (United States)

    Vorwald, Peter; Bruna Esteban, Marcos; Ortega Lucea, Sonia; Ramírez Rodríguez, Jose Manuel

    2018-03-21

    ERAS is a multimodal perioperative care program which replaces traditional practices concerning analgesia, intravenous fluids, nutrition, mobilization as well as a number of other perioperative items, whose implementation is supported by evidence-based best practices. According to the RICA guidelines published in 2015, a review of the literature and the consensus established at a multidisciplinary meeting in 2015, we present a protocol that contains the basic procedures of an ERAS pathway for resective esophageal surgery. The measures involved in this ERAS pathway are structured into 3areas: preoperative, perioperative and postoperative. The consensus document integrates all the analyzed items in a unique time chart. ERAS programs in esophageal resection surgery can reduce postoperative morbidity, mortality, hospitalization and hospital costs. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Awake craniotomy for tumor resection

    OpenAIRE

    Mohammadali Attari; Sohrab Salimi

    2013-01-01

    Surgical treatment of brain tumors, especially those located in the eloquent areas such as anterior temporal, frontal lobes, language, memory areas, and near the motor cortex causes high risk of eloquent impairment. Awake craniotomy displays major rule for maximum resection of the tumor with minimum functional impairment of the Central Nervous System. These case reports discuss the use of awake craniotomy during the brain surgery in Alzahra Hospital, Isfahan, Iran. A 56-year-old woman with le...

  8. Non-muscle-invasive bladder cancer

    DEFF Research Database (Denmark)

    Malmström, Per-Uno; Agrawal, Sachin; Bläckberg, Mats

    2017-01-01

    The management of non-muscle-invasive bladder cancer (NMIBC) has evolved from the first reports on bladder endoscopy and transurethral resection to the introduction of adjuvant intravesical treatment. However, disease recurrence and progression remain an ongoing risk, placing a heavy burden...

  9. 3D false color computed tomography for diagnosis and follow-up of permanent denervated human muscles submitted to home-based Functional Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Ugo Carraro

    2015-03-01

    Full Text Available This report outlines the use of a customized false-color 3D computed tomography (CT protocol for the imaging of the rectus femoris of spinal cord injury (SCI patients suffering from complete and permanent denervation, as characterized by complete Conus and Cauda Equina syndrome. This muscle imaging method elicits the progression of the syndrome from initial atrophy to eventual degeneration, as well as the extent to which patients' quadriceps could be recovered during four years of home-based functional electrical stimulation (h-b FES. Patients were pre-selected from several European hospitals and functionally tested by, and enrolled in the EU Commission Shared Cost Project RISE (Contract n. QLG5-CT-2001-02191 at the Department of Physical Medicine, Wilhelminenspital, Vienna, Austria. Denervated muscles were electrically stimulated using a custom-designed stimulator, large surface electrodes, and customized progressive stimulation settings. Spiral CT images and specialized computational tools were used to isolate the rectus femoris muscle and produce 3D and 2D reconstructions of the denervated muscles. The cross sections of the muscles were determined by 2D Color CT, while muscle volumes were reconstructed by 3D Color CT. Shape, volume, and density changes were measured over the entirety of each rectus femoris muscle. Changes in tissue composition within the muscle were visualized by associating different colors to specified Hounsfield unit (HU values for fat, (yellow: [-200; -10], loose connective tissue or atrophic muscle, (cyan: [-9; 40], and normal muscle, fascia and tendons included, (red: [41; 200]. The results from this analysis are presented as the average HU values within the rectus femoris muscle reconstruction, as well as the percentage of these tissues with respect to the total muscle volume. Results from this study demonstrate that h-b FES induces a compliance-dependent recovery of muscle volume and size of muscle fibers, as

  10. 3D False Color Computed Tomography for Diagnosis and Follow-Up of Permanent Denervated Human Muscles Submitted to Home-Based Functional Electrical Stimulation.

    Science.gov (United States)

    Carraro, Ugo; Edmunds, Kyle J; Gargiulo, Paolo

    2015-03-11

    This report outlines the use of a customized false-color 3D computed tomography (CT) protocol for the imaging of the rectus femoris of spinal cord injury (SCI) patients suffering from complete and permanent denervation, as characterized by complete Conus and Cauda Equina syndrome. This muscle imaging method elicits the progression of the syndrome from initial atrophy to eventual degeneration, as well as the extent to which patients' quadriceps could be recovered during four years of home-based functional electrical stimulation (h-b FES). Patients were pre-selected from several European hospitals and functionally tested by, and enrolled in the EU Commission Shared Cost Project RISE (Contract n. QLG5-CT-2001-02191) at the Department of Physical Medicine, Wilhelminenspital, Vienna, Austria. Denervated muscles were electrically stimulated using a custom-designed stimulator, large surface electrodes, and customized progressive stimulation settings. Spiral CT images and specialized computational tools were used to isolate the rectus femoris muscle and produce 3D and 2D reconstructions of the denervated muscles. The cross sections of the muscles were determined by 2D Color CT, while muscle volumes were reconstructed by 3D Color CT. Shape, volume, and density changes were measured over the entirety of each rectus femoris muscle. Changes in tissue composition within the muscle were visualized by associating different colors to specified Hounsfield unit (HU) values for fat, (yellow: [-200; -10]), loose connective tissue or atrophic muscle, (cyan: [-9; 40]), and normal muscle, fascia and tendons included, (red: [41; 200]). The results from this analysis are presented as the average HU values within the rectus femoris muscle reconstruction, as well as the percentage of these tissues with respect to the total muscle volume. Results from this study demonstrate that h-b FES induces a compliance-dependent recovery of muscle volume and size of muscle fibers, as evidenced by the

  11. Evaluation of periosteal fixation of lateral rectus and partial VRT for cases of exotropic Duane retraction syndrome

    Directory of Open Access Journals (Sweden)

    Pradeep Sharma

    2014-01-01

    Full Text Available Purpose: The purpose of this study is to evaluate the lateral rectus periosteal fixation and partial vertical rectus transpositioning (VRT as treatment modalities to correct exotropic Duane retraction syndrome (Exo-DRS. Materials and Methods: Prospective interventional case study of cases of Exo-DRS with limitation of adduction. A total of 13 patients were subdivided into two groups. Six patients underwent only lateral rectus periosteal fixation (group A and seven patients also underwent partial VRT (group B. Assessment involved prism bar cover test, abduction and adduction range, extent of binocular single visual field and exophthalmometry. These tests were repeated at 1 week, 1 month and 3 months post-operatively and data analyzed. Results: The pre-operative mean values and ranges were 26.2 Δ (22-35 exotropia for group A and −21.3 Δ (14-30 exotropia for group B. The post-operative mean and range was +0.6 Δ esotropia (+20 to −8 for group A and 8 Δ (−2 to −20 exotropia for group B. Mean grade of limitation of abduction changed from −3.8 to −3.6 versus −3.6 to −2.8 and mean grade of limitation of adduction changed from −1.9 to −0.7 versus −1.5 to −0.5 in the groups A and B respectively. Mean binocular single visual field changed from 14.7° to 23.3° in group A and 11.8° to 26.4° in the group B respectively. Conclusion: Lateral rectus periosteal fixation is an effective surgery to correct the exodeviation, anomalous head posture and improving adduction in Exo-DRS and partial VRT in addition is effective in improving abduction and binocular single visual fields.

  12. Transperitoneal rectus sheath block and transversus abdominis plane block for laparoscopic inguinal hernia repair: A novel approach.

    Science.gov (United States)

    Nagata, Jun; Watanabe, Jun; Nagata, Masato; Sawatsubashi, Yusuke; Akiyama, Masaki; Tajima, Takehide; Arase, Koichi; Minagawa, Noritaka; Torigoe, Takayuki; Nakayama, Yoshifumi; Horishita, Reiko; Kida, Kentaro; Hamada, Kotaro; Hirata, Keiji

    2017-08-01

    A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged. We report the use of a transperitoneal laparoscopic approach for rectus sheath block and transversus abdominis plane block as a novel anesthetic procedure. An 81-year-old woman with direct inguinal hernia underwent laparoscopic transabdominal preperitoneal inguinal repair. Epidural anesthesia was not performed because anticoagulant therapy was administered. A Peti-needle™ was delivered through the port, and levobupivacaine was injected though the peritoneum. Surgery was performed successfully, and the anesthetic technique did not affect completion of the operative procedure. The patient was discharged without any complications. This technique was feasible, and the procedure was performed safely. Our novel analgesia technique has potential use as a standard postoperative regimen in various laparoscopic surgeries. Additional prospective studies to compare it with other techniques are required. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  13. Decrease in pulmonary function and oxygenation after lung resection

    Directory of Open Access Journals (Sweden)

    Barbara Cristina Brocki

    2018-01-01

    Full Text Available Respiratory deficits are common following curative intent lung cancer surgery and may reduce the patient's ability to be physically active. We evaluated the influence of surgery on pulmonary function, respiratory muscle strength and physical performance after lung resection. Pulmonary function, respiratory muscle strength (maximal inspiratory/expiratory pressure and 6-min walk test (6MWT were assessed pre-operatively, 2 weeks post-operatively and 6 months post-operatively in 80 patients (age 68±9 years. Video-assisted thoracoscopic surgery was performed in 58% of cases. Two weeks post-operatively, we found a significant decline in pulmonary function (forced vital capacity −0.6±0.6 L and forced expiratory volume in 1 s −0.43±0.4 L; both p<0.0001, 6MWT (−37.6±74.8 m; p<0.0001 and oxygenation (−2.9±4.7 units; p<0.001, while maximal inspiratory and maximal expiratory pressure were unaffected. At 6 months post-operatively, pulmonary function and oxygenation remained significantly decreased (p<0.001, whereas 6MWT was recovered. We conclude that lung resection has a significant short- and long-term impact on pulmonary function and oxygenation, but not on respiratory muscle strength. Future research should focus on mechanisms negatively influencing post-operative pulmonary function other than impaired respiratory muscle strength.

  14. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain.

    Science.gov (United States)

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-06-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain.

  15. Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles during Different Sit-To-Stand Tests.

    Directory of Open Access Journals (Sweden)

    Cristina Roldán-Jiménez

    Full Text Available Sit-to-stand (STS tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG, biceps femoris (BF, vastus medialis of the quadriceps (QM, the abdominal rectus (AR, erector spinae (ES, rectus femoris (RF, soleus (SO and the tibialis anterior (TA. Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects.

  16. Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles during Different Sit-To-Stand Tests.

    Science.gov (United States)

    Roldán-Jiménez, Cristina; Bennett, Paul; Cuesta-Vargas, Antonio I

    2015-01-01

    Sit-to-stand (STS) tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG), biceps femoris (BF), vastus medialis of the quadriceps (QM), the abdominal rectus (AR), erector spinae (ES), rectus femoris (RF), soleus (SO) and the tibialis anterior (TA). Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects.

  17. Effect of knee joint angle on neuromuscular activation of the vastus intermedius muscle during isometric contraction.

    Science.gov (United States)

    Watanabe, K; Akima, H

    2011-12-01

    The purpose of this study was to compare the relationship between surface electromyography (EMG) and knee joint angle of the vastus intermedius muscle (VI) with the synergistic muscles in the quadriceps femoris (QF) muscle group. Fourteen healthy men performed maximal voluntary contractions during isometric knee extension at four knee joint angles from 90°, 115°, 140°, and 165° (180° being full extension). During the contractions, surface EMG was recorded at four muscle components of the QF muscle group: the VI, vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) muscles. The root mean square of the surface EMG at each knee joint angle was calculated and normalized by that at a knee joint angle of 90° for individual muscles. The normalized RMS of the VI muscle was significantly lower than those of the VL and RF muscles at the knee joint angles of 115° and 165° and those of the VL, VM, and RF muscles at the knee joint angle of 140° (Pneuromuscular activation of the VI muscle is regulated in a manner different from the alteration of the knee joint angle compared with other muscle components of the QF muscle group. © 2011 John Wiley & Sons A/S.

  18. Closure and augmentation of bladder exstrophy using rectus abdominis musculo-peritoneal flap

    Directory of Open Access Journals (Sweden)

    P Agarwal

    2011-01-01

    Full Text Available Background: The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. Materials and Methods: The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Results: Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. Conclusions: The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures.

  19. Optimizing the Distribution of Leg Muscles for Vertical Jumping.

    Directory of Open Access Journals (Sweden)

    Jeremy D Wong

    Full Text Available A goal of biomechanics and motor control is to understand the design of the human musculoskeletal system. Here we investigated human functional morphology by making predictions about the muscle volume distribution that is optimal for a specific motor task. We examined a well-studied and relatively simple human movement, vertical jumping. We investigated how high a human could jump if muscle volume were optimized for jumping, and determined how the optimal parameters improve performance. We used a four-link inverted pendulum model of human vertical jumping actuated by Hill-type muscles, that well-approximates skilled human performance. We optimized muscle volume by allowing the cross-sectional area and muscle fiber optimum length to be changed for each muscle, while maintaining constant total muscle volume. We observed, perhaps surprisingly, that the reference model, based on human anthropometric data, is relatively good for vertical jumping; it achieves 90% of the jump height predicted by a model with muscles designed specifically for jumping. Alteration of cross-sectional areas-which determine the maximum force deliverable by the muscles-constitutes the majority of improvement to jump height. The optimal distribution results in large vastus, gastrocnemius and hamstrings muscles that deliver more work, while producing a kinematic pattern essentially identical to the reference model. Work output is increased by removing muscle from rectus femoris, which cannot do work on the skeleton given its moment arm at the hip and the joint excursions during push-off. The gluteus composes a disproportionate amount of muscle volume and jump height is improved by moving it to other muscles. This approach represents a way to test hypotheses about optimal human functional morphology. Future studies may extend this approach to address other morphological questions in ethological tasks such as locomotion, and feature other sets of parameters such as properties of

  20. Magnetic resonance imaging, ultrasound and real-time ultrasound elastography of the thigh muscles in congenital muscle dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Drakonaki, Eleni E. [University of Crete, Radiology Department, Heraklion (Greece); Allen, Gina M. [Green Templeton College, Oxford (United Kingdom)

    2010-04-15

    Congenital muscle dystrophy includes a range of genetic disorders characterized by muscle weakness and contractures. We report the magnetic resonance (MR), ultrasound (US) and real-time sonoelastography (RTE) imaging findings of the thigh muscles of a 15-year-old boy with Bethlem myopathy diagnosed with clinical, electromyographic and histopathological criteria. Ultrasound and MR showed hyperechoic appearance and high signal intensity on T1- and T2-weighted sequences respectively at the periphery of the vastus lateralis and the long head of the biceps femoris muscles, and at a central area within the rectus femoris muscles. RTE was employed to examine the elastic properties of the muscle. The elastograms were presented as colour-coded maps superimposed on the B-mode images and revealed that the elastographic pattern correlated with the MR and US pattern of involvement. The abnormal muscle areas were stiffer (blue) than the normal-appearing areas (green), a finding that probably correlates with the presence of dystrophic collagen at the affected areas. This report suggests that RTE could be used as an additional imaging tool to evaluate the pattern of muscle changes in congenital myopathy. Further studies are needed to investigate the specificity and clinical value of RTE in the diagnosis and monitoring of neuromuscular disease. (orig.)

  1. Magnetic resonance imaging, ultrasound and real-time ultrasound elastography of the thigh muscles in congenital muscle dystrophy

    International Nuclear Information System (INIS)

    Drakonaki, Eleni E.; Allen, Gina M.

    2010-01-01

    Congenital muscle dystrophy includes a range of genetic disorders characterized by muscle weakness and contractures. We report the magnetic resonance (MR), ultrasound (US) and real-time sonoelastography (RTE) imaging findings of the thigh muscles of a 15-year-old boy with Bethlem myopathy diagnosed with clinical, electromyographic and histopathological criteria. Ultrasound and MR showed hyperechoic appearance and high signal intensity on T1- and T2-weighted sequences respectively at the periphery of the vastus lateralis and the long head of the biceps femoris muscles, and at a central area within the rectus femoris muscles. RTE was employed to examine the elastic properties of the muscle. The elastograms were presented as colour-coded maps superimposed on the B-mode images and revealed that the elastographic pattern correlated with the MR and US pattern of involvement. The abnormal muscle areas were stiffer (blue) than the normal-appearing areas (green), a finding that probably correlates with the presence of dystrophic collagen at the affected areas. This report suggests that RTE could be used as an additional imaging tool to evaluate the pattern of muscle changes in congenital myopathy. Further studies are needed to investigate the specificity and clinical value of RTE in the diagnosis and monitoring of neuromuscular disease. (orig.)

  2. Lower extremity muscle activation during baseball pitching.

    Science.gov (United States)

    Campbell, Brian M; Stodden, David F; Nixon, Megan K

    2010-04-01

    The purpose of this study was to investigate muscle activation levels of select lower extremity muscles during the pitching motion. Bilateral surface electromyography data on 5 lower extremity muscles (biceps femoris, rectus femoris, gluteus maximus, vastus medialis, and gastrocnemius) were collected on 11 highly skilled baseball pitchers and compared with individual maximal voluntary isometric contraction (MVIC) data. The pitching motion was divided into 4 distinct phases: phase 1, initiation of pitching motion to maximum stride leg knee height; phase 2, maximum stride leg knee height to stride foot contact (SFC); phase 3, SFC to ball release; and phase 4, ball release to 0.5 seconds after ball release (follow-through). Results indicated that trail leg musculature elicited moderate to high activity levels during phases 2 and 3 (38-172% of MVIC). Muscle activity levels of the stride leg were moderate to high during phases 2-4 (23-170% of MVIC). These data indicate a high demand for lower extremity strength and endurance. Specifically, coaches should incorporate unilateral and bilateral lower extremity exercises for strength improvement or maintenance and to facilitate dynamic stabilization of the lower extremities during the pitching motion.

  3. Activation of Selected Core Muscles during Pressing

    Directory of Open Access Journals (Sweden)

    Thomas W. Nesser

    2015-10-01

    Full Text Available Introduction: Unstable surface training is often used to activate core musculature during resistance training. Unfortunately, unstable surface training is risky and leads to detraining. Purpose: The purpose of this study was to determine core muscle activation during stable surface ground-based lifts. Methods: Fourteen recreational trained and former NCAA DI athletes (weight 84.2 ± 13.3 kg; height 176.0 ± 9.5 cm; age 20.9 ± 2.0 years volunteered for participation. Subjects completed two ground-based lifts: overhead press and push-press. Surface EMG was recorded from 4 muscles on the right side of the body (Rectus Abdominus (RA, External Oblique (EO, Transverse Abdominus (TA, and Erector Spinae (ES. Results: Paired sample T-tests identified significant muscle activation differences between the overhead press and the push-press included ES and EO. Average and peak EMG for ES was significantly greater in push-press (P<0.01. Anterior displacement of COP was significantly greater in push-press compared to overhead press during the eccentric phase. Conclusion: The push-press was identified as superior in core muscle activation when compared to the overhead pressing exercise. Keywords: torso, stability, weight lifting, resistance training

  4. Instrumental evaluation of colour changes in broiler breast and thigh muscles after irradiation treatment

    International Nuclear Information System (INIS)

    Zabielski, J.; Jaworska-Piasecka, A.; Stangierski, J.

    2004-01-01

    Colour changes in Biceps femoris, Rectus femoris and Pectoralis major broiler chicken muscles were determined with a reflectance colorimeter after irradiation with gamma 60Co rays. The muscles were irradiated with doses of 2, 3, 5, 7 and 10 kGy. The colour parameters L*, a* and b* were measured after 2, 5, 7 and 9 days of refrigerated storage of muscles at 1 deg C using a MINOLTA CR-200b reflectance colorimeter. The saturation of colour C* was also calculated and the significance of redness and yellowness effect on saturation was estimated by a linear regression analysis. Only in the Biceps femoris muscle were all the examined colour parameters found to be dependent both on storage time and irradiation treatment, however, the relationship between the dose and the measured effect demonstrated no linear characteristics. It was noted that the difference between the irradiated and control Biceps femoris muscles resulted from different trends of L*, b* and C* changes during storage

  5. A new MRI method for the quantitative evaluation of extraocular muscle size in thyroid ophthalmopathy

    International Nuclear Information System (INIS)

    Aydin, K.; Gueven, K.; Sencer, S.; Minareci, O.; Cikim, A.; Guel, N.

    2003-01-01

    In cross section, extraocular muscles are more or less elliptical, with short and long diameters. We studied the ratio (R) of short to long diameter and investigated its use in quantitative assessment of the extraocular muscles in patients with Graves's disease. We measured the diameters on T1-weighted axial and coronal MRI and computed R for each extraocular muscle in 80 patients without and 40 with Graves's disease. We compared the measurements and R of the right and left orbits, and of men and women. The short diameter of all extraocular muscles apart from the superior oblique showed significant differences between men and women, and that of the inferior rectus varied significantly with age. R, however, was unrelated to sex or age. All patients with Graves's disease and an increased short diameter also had an increased R, but 6% of the muscles showed an increase in R, even though their short diameter was within the normal range. (orig.)

  6. Managing Potentially Resectable Metastatic Colon Cancer

    OpenAIRE

    Marshall, John L.

    2008-01-01

    For patients with metastatic colon cancer, management has evolved from resecting a single liver metastasis and having only one chemotherapy medicine, to resecting multiple metastases including those outside the liver as well as using combination chemotherapy (based on recent supportive trials) to improve outcomes. This success has also raised many questions, including the role of adjuvant chemotherapy to downstage borderline resectable tumors, whether patients who receive preoperative chemoth...

  7. Robotic vascular resections during Whipple procedure.

    Science.gov (United States)

    Allan, Bassan J; Novak, Stephanie M; Hogg, Melissa E; Zeh, Herbert J

    2018-01-01

    Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vascular resections. This report outlines our technique.

  8. Liver resection over the last decade

    DEFF Research Database (Denmark)

    Wettergren, A.; Larsen, P.N.; Rasmussen, A.

    2008-01-01

    after resection of hepatic metastases from colorectal cancer and hepatocellular carcinoma was estimated. RESULTS: 141 patients (71M/70F), median age 58 years (1-78), underwent a liver resection in the ten-year period. The number of resections increased from two in 1995 to 32 in 2004. Median hospital...... stay was 9 days (3-38). The most frequent complication was biliary leakage (7.8%), haemorrhage (2.8%) and hepatic insufficiency (2.8%). 30-days mortality was 1.4%. The actuarial 5-survival after hepatic resection for colorectal liver metastases and hepatocellular carcinoma was 39% and 42%, respectively...

  9. Liver resection over the last decade

    DEFF Research Database (Denmark)

    Wettergren, A.; Larsen, P.N.; Rasmussen, A.

    2008-01-01

    of hepatic metastases from colorectal cancer and hepatocellular carcinoma in our institution. MATERIALS AND METHODS: The patients who underwent their primary liver resection from 1.1.1995-31.12.2004 in our institution were included. The surgical outcome was reviewed retrospectively and the five-year survival...... after resection of hepatic metastases from colorectal cancer and hepatocellular carcinoma was estimated. RESULTS: 141 patients (71M/70F), median age 58 years (1-78), underwent a liver resection in the ten-year period. The number of resections increased from two in 1995 to 32 in 2004. Median hospital...

  10. Resection of recurrent branchial cleft deformity using selective neck dissection technique.

    Science.gov (United States)

    Cai, Qian; Pan, Yong; Xu, Yaodong; Liang, Faya; Huang, Xiaoming; Jiang, Xiaoyu; Han, Ping

    2014-07-01

    This study explores application of selective neck dissection technique in recurrent second, third, and fourth branchial cleft deformities. A total of 19 cases of recurrent second, third, and fourth branchial cleft deformities were treated using the selective neck dissection technique, during which the sternocleidomastoid muscle, cervical anterior muscle, and carotid sheath were contoured. The lesion above the prevertebral fascia was then resected en bloc. Finally, the opening of the internal fistula was ligated and sutured using the purse-string approach. Patients in this study had no injures to their internal carotid artery, jugular vein, vagus nerve, accessory nerve, hypoglossal nerve, or recurrent laryngeal nerve. There were also no complications such as poor wound healing. The patients were monitored for 7-73 months and showed no recurrences. Using selective neck dissection to treat second, third, and fourth branchial cleft deformities resulted in en bloc lesion resections and reduced the chance of recurrence. Contouring the sternocleidomastoid muscle, strap muscle, and carotid sheath is key to the surgical procedure, as it leads to en bloc lesion resection while retaining the recurrent laryngeal nerve and carotid sheath. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Adaptation of slow myofibers: the effect of sustained BDNF treatment of extraocular muscles in infant nonhuman primates.

    Science.gov (United States)

    Willoughby, Christy L; Fleuriet, Jérome; Walton, Mark M; Mustari, Michael J; McLoon, Linda K

    2015-06-01

    We evaluated promising new treatment options for strabismus. Neurotrophic factors have emerged as a potential treatment for oculomotor disorders because of diverse roles in signaling to muscles and motor neurons. Unilateral treatment with sustained release brain-derived neurotrophic factor (BDNF) to a single lateral rectus muscle in infant monkeys was performed to test the hypothesis that strabismus would develop in correlation with extraocular muscle (EOM) changes during the critical period for development of binocularity. The lateral rectus muscles of one eye in two infant macaques were treated with sustained delivery of BDNF for 3 months. Eye alignment was assessed using standard photographic methods. Muscle specimens were analyzed to examine the effects of BDNF on the density, morphology, and size of neuromuscular junctions, as well as myofiber size. Counts were compared to age-matched controls. No change in eye alignment occurred with BDNF treatment. Compared to control muscle, neuromuscular junctions on myofibers expressing slow myosins had a larger area. Myofibers expressing slow myosin had larger diameters, and the percentage of myofibers expressing slow myosins increased in the proximal end of the muscle. Expression of BDNF was examined in control EOM, and observed to have strongest immunoreactivity outside the endplate zone. We hypothesize that the oculomotor system adapted to sustained BDNF treatment to preserve normal alignment. Our results suggest that BDNF treatment preferentially altered myofibers expressing slow myosins. This implicates BDNF signaling as influencing the slow twitch properties of EOM.

  12. Assessment of Whole Body and Local Muscle Fatigue Using Electromyography and a Perceived Exertion Scale for Squat Lifting

    Directory of Open Access Journals (Sweden)

    Imran Ahmad

    2018-04-01

    Full Text Available This research study aims at addressing the paradigm of whole body fatigue and local muscle fatigue detection for squat lifting. For this purpose, a comparison was made between perceived exertion with the heart rate and normalized mean power frequency (NMPF of eight major muscles. The sample consisted of 25 healthy males (age: 30 ± 2.2 years. Borg’s CR-10 scale was used for perceived exertion for two segments of the body (lower and upper and the whole body. The lower extremity of the body was observed to be dominant compared to the upper and whole body in perceived response. First mode of principal component analysis (PCA was obtained through the covariance matrix for the eight muscles for 25 subjects for NMPF of eight muscles. The diagonal entries in the covariance matrix were observed for each muscle. The muscle with the highest absolute magnitude was observed across all the 25 subjects. The medial deltoid and the rectus femoris muscles were observed to have the highest frequency for each PCA across 25 subjects. The rectus femoris, having the highest counts in all subjects, validated that the lower extremity dominates the sense of whole body fatigue during squat lifting. The findings revealed that it is significant to take into account the relation between perceived and measured effort that can help prevent musculoskeletal disorders in repetitive occupational tasks.

  13. Assessment of Whole Body and Local Muscle Fatigue Using Electromyography and a Perceived Exertion Scale for Squat Lifting.

    Science.gov (United States)

    Ahmad, Imran; Kim, Jung-Yong

    2018-04-18

    This research study aims at addressing the paradigm of whole body fatigue and local muscle fatigue detection for squat lifting. For this purpose, a comparison was made between perceived exertion with the heart rate and normalized mean power frequency (NMPF) of eight major muscles. The sample consisted of 25 healthy males (age: 30 ± 2.2 years). Borg’s CR-10 scale was used for perceived exertion for two segments of the body (lower and upper) and the whole body. The lower extremity of the body was observed to be dominant compared to the upper and whole body in perceived response. First mode of principal component analysis (PCA) was obtained through the covariance matrix for the eight muscles for 25 subjects for NMPF of eight muscles. The diagonal entries in the covariance matrix were observed for each muscle. The muscle with the highest absolute magnitude was observed across all the 25 subjects. The medial deltoid and the rectus femoris muscles were observed to have the highest frequency for each PCA across 25 subjects. The rectus femoris, having the highest counts in all subjects, validated that the lower extremity dominates the sense of whole body fatigue during squat lifting. The findings revealed that it is significant to take into account the relation between perceived and measured effort that can help prevent musculoskeletal disorders in repetitive occupational tasks.

  14. The Gross Morphology and Histochemistry of Respiratory Muscles in Bottlenose Dolphins, Tursiops truncatus

    Science.gov (United States)

    Cotten, Pamela B.; Piscitelli, Marina A.; McLellan, William A.; Rommel, Sentiel A.; Dearolf, Jennifer L.; Pabst, D. Ann

    2011-01-01

    Most mammals possess stamina because their locomotor and respiratory (i.e., ventilatory) systems are mechanically coupled. These systems are decoupled, however, in bottlenose dolphins (Tursiops truncatus) as they swim on a breath-hold. Locomotion and ventilation are coupled only during their brief surfacing event, when they respire explosively (up to 90% of total lung volume in approximately 0.3s) (Ridgway et al., 1969). The predominantly slow-twitch fiber profile of their diaphragm (Dearolf, 2003) suggests that this muscle does not likely power their rapid ventilatory event. Based upon Bramble's (1989) biomechanical model of locomotor-respiratory coupling in galloping mammals, it was hypothesized that locomotor muscles function to power ventilation in bottlenose dolphins. It was further hypothesized that these muscles would be composed predominantly of fast-twitch fibers to facilitate the bottlenose dolphin's rapid ventilation. The gross morphology of cranio-cervical (scalenus, sternocephalicus, sternohyoid), thoracic (intercostals, transverse thoracis), and lumbo-pelvic (hypaxialis, rectus abdominis, abdominal obliques) muscles (n=7) and the fiber-type profiles (n=6) of selected muscles (scalenus, sternocephalicus, sternohyoid, rectus abdominis) of bottlenose dolphins were investigated. Physical manipulations of excised thoracic units were carried out to investigate potential actions of these muscles. Results suggest that the cranio-cervical muscles act to draw the sternum and associated ribs cranio-dorsally, which flares the ribs laterally, and increases the thoracic cavity volume required for inspiration. The lumbo-pelvic muscles act to draw the sternum and caudal ribs caudally, which decreases the volumes of the thoracic and abdominal cavities required for expiration. All muscles investigated were composed predominantly of fast-twitch fibers (range 61-88% by area) and appear histochemically poised for rapid contraction. These combined results suggest that

  15. Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography.

    Science.gov (United States)

    Chino, Kentaro; Kawakami, Yasuo; Takahashi, Hideyuki

    2017-07-01

    The aim of the present study was to measure in vivo skeletal muscle elasticity in the transverse and longitudinal planes using shear wave elastography and then to compare the image stability, measurement values and measurement repeatability between these imaging planes. Thirty-one healthy males participated in this study. Tissue elasticity (shear wave velocity) of the medial gastrocnemius, rectus femoris, biceps brachii and rectus abdominis was measured in both the transverse and longitudinal planes using shear wave elastography. Image stability was evaluated by the standard deviation of the colour distribution in the shear wave elastography image. Measurement repeatability was assessed by the coefficient of variance obtained from three measurement values. Image stability of all tested muscles was significantly higher in the longitudinal plane (Pplanes (P>0·05), except in the biceps brachii (P = 0·001). Measurement values of the medial gastrocnemius, rectus femoris and biceps brachii were significantly different between the imaging planes (Pplane, which indicates that imaging plane should be considered when measuring skeletal muscle tissue elasticity by shear wave elastography. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  16. Minilaparoscopic Colorectal Resections: Technical Note

    Directory of Open Access Journals (Sweden)

    S. Bona

    2012-01-01

    Full Text Available Laparoscopic colorectal resections have been shown to provide short-term advantages in terms of postoperative pain, general morbidity, recovery, and quality of life. To date, long-term results have been proved to be comparable to open surgery irrefutably only for colon cancer. Recently, new trends keep arising in the direction of minimal invasiveness to reduce surgical trauma after colorectal surgery in order to improve morbidity and cosmetic results. The few reports available in the literature on single-port technique show promising results. Natural orifices endoscopic techniques still have very limited application. We focused our efforts in standardising a minilaparoscopic technique (using 3 to 5 mm instruments for colorectal resections since it can provide excellent cosmetic results without changing the laparoscopic approach significantly. Thus, there is no need for a new learning curve as minilaparoscopy maintains the principle of instrument triangulation. This determines an undoubted advantage in terms of feasibility and reproducibility of the procedure without increasing operative time. Some preliminary experiences confirm that minilaparoscopic colorectal surgery provides acceptable results, comparable to those reported for laparoscopic surgery with regard to operative time, morbidity, and hospital stay. Randomized controlled studies should be conducted to confirm these early encouraging results.

  17. Optimizing the Distribution of Leg Muscles for Vertical Jumping

    Science.gov (United States)

    Wong, Jeremy D.; Bobbert, Maarten F.; van Soest, Arthur J.; Gribble, Paul L.; Kistemaker, Dinant A.

    2016-01-01

    A goal of biomechanics and motor control is to understand the design of the human musculoskeletal system. Here we investigated human functional morphology by making predictions about the muscle volume distribution that is optimal for a specific motor task. We examined a well-studied and relatively simple human movement, vertical jumping. We investigated how high a human could jump if muscle volume were optimized for jumping, and determined how the optimal parameters improve performance. We used a four-link inverted pendulum model of human vertical jumping actuated by Hill-type muscles, that well-approximates skilled human performance. We optimized muscle volume by allowing the cross-sectional area and muscle fiber optimum length to be changed for each muscle, while maintaining constant total muscle volume. We observed, perhaps surprisingly, that the reference model, based on human anthropometric data, is relatively good for vertical jumping; it achieves 90% of the jump height predicted by a model with muscles designed specifically for jumping. Alteration of cross-sectional areas—which determine the maximum force deliverable by the muscles—constitutes the majority of improvement to jump height. The optimal distribution results in large vastus, gastrocnemius and hamstrings muscles that deliver more work, while producing a kinematic pattern essentially identical to the reference model. Work output is increased by removing muscle from rectus femoris, which cannot do work on the skeleton given its moment arm at the hip and the joint excursions during push-off. The gluteus composes a disproportionate amount of muscle volume and jump height is improved by moving it to other muscles. This approach represents a way to test hypotheses about optimal human functional morphology. Future studies may extend this approach to address other morphological questions in ethological tasks such as locomotion, and feature other sets of parameters such as properties of the skeletal

  18. Quadriceps muscle use in the flywheel and barbell squat.

    Science.gov (United States)

    Norrbrand, Lena; Tous-Fajardo, Julio; Vargas, Roberto; Tesch, Per A

    2011-01-01

    Resistance exercise has been proposed as an aid to counteract quadriceps muscle atrophy in astronauts during extended missions in orbit. While space authorities have advocated the squat exercise should be prescribed, no exercise system suitable for in-flight use has been validated with regard to quadriceps muscle use. We compared muscle involvement in the terrestrial "gold standard" squat using free weights and a nongravity dependent flywheel resistance exercise device designed for use in space. The subjects were 10 strength-trained men who performed 5 sets of 10 repetitions using the barbell squat (BS; 10 repetition maximum) or flywheel squat (FS; each repetition maximal), respectively. Functional magnetic resonance imaging (MRI) and surface electromyography (EMG) techniques assessed quadriceps muscle use. Exercise-induced contrast shift of MR images was measured by means of transverse relaxation time (T2). EMG root mean square (RMS) was measured during concentric (CON) and eccentric (ECC) actions and normalized to EMG RMS determined during maximal voluntary contraction. The quadriceps muscle group showed greater exercise-induced T2 increase following FS compared with BS. Among individual muscles, the rectus femoris displayed greater T2 increase with FS (+24 +/- 14%) than BS (+8 +/- 4%). Normalized quadriceps EMG showed no difference across exercise modes. Collectively, the results of this study suggest that quadriceps muscle use in the squat is comparable, if not greater, with flywheel compared with free weight resistance exercise. Data appear to provide support for use of flywheel squat resistance exercise as a countermeasures adjunct during spaceflight.

  19. Muscle Activation during Gait in Children with Duchenne Muscular Dystrophy.

    Science.gov (United States)

    Ropars, Juliette; Lempereur, Mathieu; Vuillerot, Carole; Tiffreau, Vincent; Peudenier, Sylviane; Cuisset, Jean-Marie; Pereon, Yann; Leboeuf, Fabien; Delporte, Ludovic; Delpierre, Yannick; Gross, Raphaël; Brochard, Sylvain

    2016-01-01

    The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD). Dynamic surface electromyography recordings (EMGs) of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF), vastus lateralis (VL), medial hamstrings (HS), tibialis anterior (TA) and gastrocnemius soleus (GAS) muscles was recorded and analysed quantitatively and qualitatively. The overall muscle activity in the children with DMD was significantly different from that of the control group. Percentage activation amplitudes of RF, HS and TA were greater throughout the gait cycle in the children with DMD and the timing of GAS activity differed from the control children. Significantly greater muscle coactivation was found in the children with DMD. There were no significant differences between sides. Since the motor command is normal in DMD, the hyper-activity and co-contractions likely compensate for gait instability and muscle weakness, however may have negative consequences on the muscles and may increase the energy cost of gait. Simple rehabilitative strategies such as targeted physical therapies may improve stability and thus the pattern of muscle activity.

  20. Muscle Activation during Gait in Children with Duchenne Muscular Dystrophy.

    Directory of Open Access Journals (Sweden)

    Juliette Ropars

    Full Text Available The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD. Dynamic surface electromyography recordings (EMGs of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF, vastus lateralis (VL, medial hamstrings (HS, tibialis anterior (TA and gastrocnemius soleus (GAS muscles was recorded and analysed quantitatively and qualitatively. The overall muscle activity in the children with DMD was significantly different from that of the control group. Percentage activation amplitudes of RF, HS and TA were greater throughout the gait cycle in the children with DMD and the timing of GAS activity differed from the control children. Significantly greater muscle coactivation was found in the children with DMD. There were no significant differences between sides. Since the motor command is normal in DMD, the hyper-activity and co-contractions likely compensate for gait instability and muscle weakness, however may have negative consequences on the muscles and may increase the energy cost of gait. Simple rehabilitative strategies such as targeted physical therapies may improve stability and thus the pattern of muscle activity.

  1. Which patients with resectable pancreatic cancer truly benefit from oncological resection: is it destiny or biology?

    Science.gov (United States)

    Zheng, Lei; Wolfgang, Christopher L

    2015-01-01

    Pancreatic cancer has a dismal prognosis. A technically perfect surgical operation may still not provide a survival advantage for patients with technically resectable pancreatic cancer. Appropriate selection of patients for surgical resections is an imminent issue. Recent studies have provided an important clue on what serum biomarkers may be used to select out the patients who would unlikely benefit from the surgical resection.

  2. Hypothenar hammer syndrome: caused by a muscle anomaly? A case report with review of the literature.

    Science.gov (United States)

    Estermann, Lea; Ducommun, Pascal; Steurer-Dober, Isabelle; Hug, Urs

    2018-05-01

    The hypothenar hammer syndrome (HHS) is a rare entity of secondary Raynaud's phenomenon. The blunt hypothenar trauma causes a lesion of the vessel wall with a consecutive thrombosis or aneurysm of the ulnar artery at the Guyon's canal. Different risk factors are discussed such as nicotine abuse, or a muscle anomaly in the Guyon's canal. To date, there are five case reports published about muscle anomalies and HHS. We present a case of a 51-year-old shipbuilder with a unilateral HHS on his right dominant hand with a bilateral muscle anomaly. We successfully treated the patient by resection of the aneurysm without a resection of the atypical muscle.

  3. Muscle Contraction.

    Science.gov (United States)

    Sweeney, H Lee; Hammers, David W

    2018-02-01

    SUMMARYMuscle cells are designed to generate force and movement. There are three types of mammalian muscles-skeletal, cardiac, and smooth. Skeletal muscles are attached to bones and move them relative to each other. Cardiac muscle comprises the heart, which pumps blood through the vasculature. Skeletal and cardiac muscles are known as striated muscles, because the filaments of actin and myosin that power their contraction are organized into repeating arrays, called sarcomeres, that have a striated microscopic appearance. Smooth muscle does not contain sarcomeres but uses the contraction of filaments of actin and myosin to constrict blood vessels and move the contents of hollow organs in the body. Here, we review the principal molecular organization of the three types of muscle and their contractile regulation through signaling mechanisms and discuss their major structural and functional similarities that hint at the possible evolutionary relationships between the cell types. Copyright © 2018 Cold Spring Harbor Laboratory Press; all rights reserved.

  4. Adjuvant chemotherapy for superficial transitional cell bladder carcinoma : Long-term results of a European organization for research and treatment of cancer randomized trial comparing doxorubicin, ethoglucid and transurethral resection alone

    NARCIS (Netherlands)

    Kurth, K; Tunn, U; Ay, R; Schroder, FH; PavoneMacaluso, M; Debruyne, F; TenKate, F; DePauw, M; Sylvester, R; Essed, E; Caubergh, RV; Hoekstra, JW; deVoogt, HJ; Newling, DWW; deReijke, TM; Mensink, HJA; Groen, JM; Jakse, G; Leisinger, HJ; Richards, B; Adib, RA; Robinson, M; Denis, L; Bouffioux, C; Schulman, C; Carpentier, PJ

    Purpose: We compared the efficacy of transurethral resection alone or transurethral resection followed by bladder instillations of doxorubicin or ethoglucid for 1 year in patients with superficial bladder carcinoma, and followed them long term for the incidence of progression to muscle invasion.

  5. Muscle ultrasound elastography and MRI in preschool children with Duchenne muscular dystrophy.

    Science.gov (United States)

    Pichiecchio, Anna; Alessandrino, Francesco; Bortolotto, Chandra; Cerica, Alessandra; Rosti, Cristina; Raciti, Maria Vittoria; Rossi, Marta; Berardinelli, Angela; Baranello, Giovanni; Bastianello, Stefano; Calliada, Fabrizio

    2018-06-01

    The aim of this study was to determine muscle tissue elasticity, measured with shear-wave elastography, in selected lower limb muscles of patients affected by Duchenne muscular dystrophy (DMD) and to correlate the values obtained with those recorded in healthy children and with muscle magnetic resonance imaging (MRI) data from the same DMD children, specifically the pattern on T1-weighted (w) and short-tau inversion recovery (STIR) sequences. Five preschool DMD children and five age-matched healthy children were studied with shear-wave elastography. In the DMD children, muscle stiffness was moderately higher compared with the muscle stiffness in HC, in the rectus femoris, vastus lateralis, adductor magnus and gluteus maximus muscles. On muscle MRI T1-w images showed fatty replacement in 3/5 patients at the level of the GM, while thigh and leg muscles were affected in 2/5; hyperintensity on STIR images was identified in 4/5 patients. No significant correlation was observed between stiffness values and MRI scoring. Our study demonstrated that lower limb muscles of preschool DMD patients show fatty replacement and patchy edema on muscle MRI and increased stiffness on shear-wave elastography. In conclusion, although further studies in larger cohorts are needed, shear-wave elastography could be considered a useful non-invasive tool to easily monitor muscle changes in early stages of the disease. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Effect of Constraint Loading on the Lower Limb Muscle Forces in Weightless Treadmill Exercise

    Directory of Open Access Journals (Sweden)

    Ning Guo

    2018-01-01

    Full Text Available Long exposure to the microgravity will lead to muscle atrophy and bone loss. Treadmill exercise could mitigate the musculoskeletal decline. But muscle atrophy remains inevitable. The constraint loading applied on astronauts could affect the muscle force and its atrophy severity. However, the quantitative correlation between constraint loading mode and muscle forces remains unclear. This study aimed to characterize the influence of constraint loading mode on the lower limb muscle forces in weightless treadmill exercise. The muscle forces in the full gait cycle were calculated with the inverse dynamic model of human musculoskeletal system. The calculated muscle forces at gravity were validated with the EMG data. Muscle forces increased at weightlessness compared with those at the earth’s gravity. The increasing percentage from high to low is as follows: biceps femoris, gastrocnemius, soleus, vastus, and rectus femoris, which was in agreement with the muscle atrophy observed in astronauts. The constraint loading mode had an impact on the muscle forces in treadmill exercise and thus could be manipulated to enhance the effect of the muscle training in spaceflight. The findings could provide biomechanical basis for the optimization of treadmill constraint system and training program and improve the countermeasure efficiency in spaceflight.

  7. Biliary Stricture Following Hepatic Resection

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Matthews

    1991-01-01

    Full Text Available Anatomic distortion and displacement of hilar structures due to liver lobe atrophy and hypertrophy occasionally complicates the surgical approach for biliary stricture repair. Benign biliary stricture following hepatic resection deserves special consideration in this regard because the inevitable hypertrophy of the residual liver causes marked rotation and displacement of the hepatic hilum that if not anticipated may render exposure for repair difficult and dangerous. Three patients with biliary stricture after hepatectomy illustrate the influence of hepatic regeneration on attempts at subsequent stricture repair. Following left hepatectomy, hypertrophy of the right and caudate lobes causes an anteromedial rotation and displacement of the portal structures. After right hepatectomy, the rotation is posterolateral, and a thoracoabdominal approach may be necessary for adequate exposure. Radiographs obtained in the standard anteroposterior projection may be deceptive, and lateral views are recommended to aid in operative planning.

  8. Fast-track rehabilitation following video-assisted pulmonary sublobar wedge resection: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Christos Asteriou

    2016-01-01

    Full Text Available Background: Postoperative morbidity and inhospital length of stay are considered major determinants of total health care expenditure associated with thoracic operations. The aim of this study was to prospectively evaluate the role of video-assisted thoracic surgery (VATS compared to mini-muscle-sparing thoracotomy in facilitating early recovery and hospital discharge after pulmonary sublobar wedge resections. Patients and Methods: A total number of 120 patients undergoing elective pulmonary sublobar wedge resection were randomly assigned to VATS (n = 60 or mini-muscle-sparing thoracotomy (n = 60. The primary endpoint was time to hospital discharge. Postoperative complications, cardiopulmonary morbidity and 30-day mortality served as secondary endpoints. Results: Patients' baseline demographic and clinical data did not differ among study arms as well as the number of pulmonary segments resected and the morphology of the nodular lesions. Total hospital stay was significantly shorter in patients assigned to the thoracoscopic technique as opposed to those who were operated using the mini-muscle-sparing thoracotomy approach (4 ± 0.6 versus 4.4 ± 0.6 days respectively, P = 0.006. Multivariate analysis revealed that VATS approach was inversely associated with longer inhospital stay whereas the number of resected segments was positively associated with an increased duration of hospitalization. Patients in the VATS group were less likely to develop atelectasis (≥1 lobe compared to those who underwent thoracotomy (0% versus 6.7% respectively, P = 0.042. Kaplan-Meier analysis revealed similar 30-day mortality rates in both study arms (Log-rank P = 0.560. Conclusion: VATS was associated with shorter duration of hospitalization positively affecting the patients' quality of life and satisfaction. Significant suppression of the total cost of recovery after thoracoscopic pulmonary resections is expected.

  9. The resection angle in apical surgery

    DEFF Research Database (Denmark)

    von Arx, Thomas; Janner, Simone F M; Jensen, Simon S

    2016-01-01

    OBJECTIVES: The primary objective of the present radiographic study was to analyse the resection angle in apical surgery and its correlation with treatment outcome, type of treated tooth, surgical depth and level of root-end filling. MATERIALS AND METHODS: In the context of a prospective clinical...... study, cone beam computed tomography (CBCT) scans were taken before and 1 year after apical surgery to measure the angle of the resection plane relative to the longitudinal axis of the root. Further, the surgical depth (distance from the buccal cortex to the most lingual/palatal point of the resection...... or with the retrofilling length. CONCLUSIONS: Statistically significant differences were observed comparing resection angles of different tooth groups. However, the angle had no significant effect on treatment outcome. CLINICAL RELEVANCE: Contrary to common belief, the resection angle in maxillary anterior teeth...

  10. Safe Resection and Primary Anastomosis of Gangrenous Sigmoid ...

    African Journals Online (AJOL)

    %) of the sigmoid volvulus was gangrenous and 85.2% of all the sigmoid volvulus was managed by resection and primary anastomosis. Complications seen after resection and primary anastomosis were anastomotic leak at 4.5%, resection.

  11. Timing of muscle response to a sudden leg perturbation: comparison between adolescents and adults with Down syndrome.

    Directory of Open Access Journals (Sweden)

    Maria Stella Valle

    Full Text Available Movement disturbances associated with Down syndrome reduce mechanical stability, worsening the execution of important tasks such as walking and upright standing. To compensate these deficits, persons with Down syndrome increase joint stability modulating the level of activation of single muscles or producing an agonist-antagonist co-activation. Such activations are also observed when a relaxed, extended leg is suddenly released and left to oscillate passively under the influence of gravity (Wartenberg test. In this case, the Rectus femoris of adults with Down syndrome displayed peaks of activation after the onset of the first leg flexion. With the aim to verify if these muscular reactions were acquired during the development time and to find evidences useful to give them a functional explanation, we used the Wartenberg test to compare the knee joint kinematics and the surface electromyography of the Rectus femoris and Biceps femoris caput longus between adolescents and adults with Down syndrome. During the first leg flexion, adolescents and adults showed single Rectus femoris activations while, a restricted number of participants exhibited agonist-antagonist co-activations. However, regardless the pattern of activation, adults initiated the muscle activity significantly later than adolescents. Although most of the mechanical parameters and the total movement variability were similar in the two groups, the onset of the Rectus femoris activation was well correlated with the time of the minimum acceleration variability. Thus, in adolescents the maximum mechanical stability occurred short after the onset of the leg fall, while adults reached their best joint stability late during the first flexion. These results suggest that between the adolescence and adulthood, persons with Down syndrome explore a temporal window to select an appropriate timing of muscle activation to overcome their inherent mechanical instability.

  12. Clinicodemographic aspect of resectable pancreatic cancer and prognostic factors for resectable cancer

    Directory of Open Access Journals (Sweden)

    Chiang Kun-Chun

    2012-05-01

    Full Text Available Abstract Background Pancreatic adenocarcinoma (PCA is one of the most lethal human malignancies, and radical surgery remains the cornerstone of treatment. After resection, the overall 5-year survival rate is only 10% to 29%. At the time of presentation, however, about 40% of patients generally have distant metastases and another 40% are usually diagnosed with locally advanced cancers. The remaining 20% of patients are indicated for surgery on the basis of the results of preoperative imaging studies; however, about half of these patients are found to be unsuitable for resection during surgical exploration. In the current study, we aimed to determine the clinicopathological characteristics that predict the resectability of PCA and to conduct a prognostic analysis of PCA after resection to identify favorable survival factors. Methods We retrospectively reviewed the medical files of 688 patients (422 men and 266 women who had undergone surgery for histopathologically proven PCA in the Department of Surgery at Chang Gung Memorial Hospital in Taiwan from 1981 to 2006. We compared the clinical characteristics of patients who underwent resection and patients who did not undergo resection in order to identify the predictive factors for successful resectability of PCA, and we conducted prognostic analysis for PCA after resection. Results A carbohydrate antigen 19–9 (CA 19–9 level of 37 U/ml or greater and a tumor size of 3 cm or more independently predicted resectability of PCA. In terms of survival after resection, PCA patients with better nutritional status (measured as having an albumin level greater than 3.5 g/dl, radical resection, early tumor stage and better-differentiated tumors were associated with favorable survival. Conclusions Besides traditional imaging studies, preoperative CA 19–9 levels and tumor size can also be used to determine the resectability of PCA. Better nutritional status, curative resection, early tumor stage and well

  13. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy.

    Directory of Open Access Journals (Sweden)

    Lynn Bar-On

    Full Text Available The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n = 35/19; 10.8 ± 3.8 yrs; bilateral/unilateral involvement n =  32/22; Gross Motor Functional Classification Score I-IV of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01. The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between

  14. Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings.

    Directory of Open Access Journals (Sweden)

    Brian Chin Wing Kot

    Full Text Available Standardization on Shear wave ultrasound elastography (SWUE technical settings will not only ensure that the results are accurate, but also detect any differences over time that may be attributed to true physiological changes. The present study evaluated the variations of elastic modulus of muscle and tendon using SWUE when different technical aspects were altered. The results of this study indicated that variations of elastic modulus of muscle and tendon were found when different transducer's pressure and region of interest (ROI's size were applied. No significant differences in elastic modulus of the rectus femoris muscle and patellar tendon were found with different acquisition times of the SWUE sonogram. The SWUE on the muscle and tendon should be performed with the lightest transducer's pressure, a shorter acquisition time for the SWUE sonogram, while measuring the mean elastic modulus regardless the ROI's size.

  15. Skeletal muscle CT of lower extremities in myotonic dystrophy

    International Nuclear Information System (INIS)

    Takahashi, Ryosuke; Imai, Terukuni; Sadashima, Hiromichi; Matsumoto, Sadayuki; Yamamoto, Toru; Kusaka, Hirofumi; Yamasaki, Masahiro; Maya, Kiyomi; Tanabe, Masaya

    1988-01-01

    We evaluated the leg and thigh muscles of 4 control subjects and 10 patients with myotonic dystrophy using computed tomography. Taking previous reports about the skeletal muscle CT of myotonic dystrophy into account, we concluded that the following 5 features are characteristic of myotonic dystrophy: 1. The main change is the appearance of low-density areas in muscles; these areas reflect fat tissue. In addition, the muscle mass decreases in size. 2. The leg is more severely affected than the thigh. 3. In the thigh, although the m. quadriceps femoris, especially the vastus muscles, tends to be affected, the m. adductor longus and magnus tend to be preserved. 4. In the leg, although the m. tibialis anterior and m. triceps surae tend to be affected, the m. peroneus longus, brevis, and m. tibialis posterior tend to be preserved. 5. Compensatory hypertrophy is often observed in the m. rectus femoris, m. adductor longus, m. adductor magnus, m. peroneus longus, and m. peroneus brevis, accompanied by the involvement of their agonist muscles. (author)

  16. Is muscle coordination affected by loading condition in ballistic movements?

    Science.gov (United States)

    Giroux, Caroline; Guilhem, Gaël; Couturier, Antoine; Chollet, Didier; Rabita, Giuseppe

    2015-02-01

    This study aimed to investigate the effect of loading on lower limb muscle coordination involved during ballistic squat jumps. Twenty athletes performed ballistic squat jumps on a force platform. Vertical force, velocity, power and electromyographic (EMG) activity of lower limb muscles were recorded during the push-off phase and compared between seven loading conditions (0-60% of the concentric-only maximal repetition). The increase in external load increased vertical force (from 1962 N to 2559 N; P=0.0001), while movement velocity decreased (from 2.5 to 1.6 ms(-1); P=0.0001). EMG activity of tibialis anterior first peaked at 5% of the push-off phase, followed by gluteus maximus (35%), vastus lateralis and soleus (45%), rectus femoris (55%), gastrocnemius lateralis (65%) and semitendinosus (75%). This sequence of activation (P=0.67) and the amplitude of muscle activity (P=0.41) of each muscle were not affected by loading condition. However, a main effect of muscle was observed on these parameters (peak value: Ppush-off phase. Our findings suggest that muscle coordination is not influenced by external load during a ballistic squat jump. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Effect of routine repeat transurethral resection for superficial bladder cancer: a long-term observational study.

    Science.gov (United States)

    Grimm, Marc-Oliver; Steinhoff, Christine; Simon, Xenia; Spiegelhalder, Philipp; Ackermann, Rolf; Vogeli, Thomas Alexander

    2003-08-01

    We determined the long-term outcome in patients with superficial bladder cancer (Ta and T1) undergoing routine second transurethral bladder tumor resection (ReTURB) in regard to recurrence and progression. We performed an inception cohort study of 124 consecutive patients with superficial bladder cancer undergoing transurethral resection and routine ReTURB (83) between November 1993 and October 1995 at a German university hospital. Immediately after transurethral resection all lesions were documented on a designed bladder map. ReTURB of the scar from initial resection and other suspicious lesions was performed at a mean of 7 weeks. Patients were followed until recurrence or death, or a minimum of 5 years. Residual tumor was found in 33% of all ReTURB cases, including 27% of Ta and 53% of T1 disease, and in 81% at the initial resection site. Five of the 83 patients underwent radical cystectomy due to ReTURB findings. The estimated risk of recurrence after years 1 to 3 was 18%, 29% and 32%, respectively. After 5 years 63% of the patients undergoing ReTURB were still disease-free (mean recurrence-free survival 62 months, median 87). Progression to muscle invasive disease was observed in only 2 patients (3%) after a mean observation of 61 months. These data suggest a favorable outcome regarding recurrence and progression in patients with superficial bladder cancer who undergo ReTURB. ReTURB is suggested at least in those at high risk when bladder preservation is intended.

  18. Vacuum-assisted closure for open perineal wound after abdominoperineal resection.

    Science.gov (United States)

    Fujino, Shiki; Miyoshi, Norikatsu; Ohue, Masayuki; Noura, Shingo; Fujiwara, Yoshiyuki; Yano, Masahiko; Higashiyama, Masahiko; Sakon, Masato

    2015-01-01

    In colorectal cancer surgery, surgical site infection (SSI) is a common complication, and especially, perineal wound complications after abdominoperineal resection (APR) remain to be serious clinical problems. Vacuum-assisted closure (VAC) therapy was first reported in another surgical field in 1997, and it is useful for treating complex wounds because it promotes granulation. VAC therapy has been recently used for open abdominal wounds. We introduced VAC for treating open perineal wound of APR and report the usefulness of it. We treated four patients. Firstly, in cases 1 and 2, we introduced VAC therapy to the management of SSI of the perineal wound after APR, and it was useful to control postoperative perineal wound infection. And also, in cases 3 and 4, we introduced VAC therapy to prevent perineal wound infection. Perineal wound infection did not happen. A vertical rectus abdominis myocutaneous flap has been reported to decrease perineal wound complications including pelvic abscess and open perineal wound; however it results in significant operative blood loss, increased operative time, and additional surgical complications. In our cases, there were no complications relating to VAC therapy and it promoted rapid wound healing. Our results suggested that it is an effective treatment for APR in a high-risk case of an open perineal wound. VAC therapy is a less invasive method and a useful treatment for open perineal wound of APR. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Contemporary Management of Localized Resectable Pancreatic Cancer.

    Science.gov (United States)

    Kommalapati, Anuhya; Tella, Sri Harsha; Goyal, Gaurav; Ma, Wen Wee; Mahipal, Amit

    2018-01-20

    Pancreatic cancer is the third most common cause of cancer deaths in the United States. Surgical resection with negative margins still constitutes the cornerstone of potentially curative therapy, but is possible only in 15-20% of patients at the time of initial diagnosis. Accumulating evidence suggests that the neoadjuvant approach may improve R0 resection rate in localized resectable and borderline resectable diseases, and potentially downstage locally advanced disease to achieve surgical resection, though the impact on survival is to be determined. Despite advancements in the last decade in developing effective combinational chemo-radio therapeutic options, preoperative treatment strategies, and better peri-operative care, pancreatic cancer continues to carry a dismal prognosis in the majority. Prodigious efforts are currently being made in optimizing the neoadjuvant therapy with a better toxicity profile, developing novel agents, imaging techniques, and identification of biomarkers for the disease. Advancement in our understanding of the tumor microenvironment and molecular pathology is urgently needed to facilitate the development of novel targeted and immunotherapies for this setting. In this review, we detail the current literature on contemporary management of resectable, borderline resectable and locally advanced pancreatic cancer with a focus on future directions in the field.

  20. Quantifying muscle patterns and spine load during various forms of the push-up.

    Science.gov (United States)

    Freeman, Stephanie; Karpowicz, Amy; Gray, John; McGill, Stuart

    2006-03-01

    This study was conducted to quantify the normalized amplitudes of the abdominal wall and back extensor musculature during a variety of push-up styles. We also sought to quantify their impact on spinal loading by calculating spinal compression and torque generation in the L4-5 area. Ten university-age participants, nine males and one female, in good to excellent condition, volunteered to participate in this study. All participants were requested to perform a maximum of 12 different push-up exercises, three trials per exercise. Surface electromyographic data (EMG) were collected bilaterally on rectus abdominis, external oblique, internal oblique, latissimus dorsi, and erector spinae muscles, and unilaterally (right side) on pectoralis major, triceps brachii, biceps brachii, and anterior deltoid muscles. Spine kinetics were obtained using an anatomically detailed model of the torso/spine. This study revealed that more dynamic push-ups (i.e., ballistic, with hand movement) required more muscle activation and higher spine load, whereas placing labile balls under the hands only resulted in modest increases in spine load. Right rectus abdominis (RA) activation was significantly higher than left RA activation during the left hand forward push-up and vice versa for the right hand forward push-up (P push-ups (P push-up resulted in the highest spine compression. Skilled participants showed greater synchronicity with peak muscle activation (plyometric type of contractions) during ballistic push-ups. These data will help guide exercise selection for individuals with differing training objectives and injury history.

  1. Differences between novice and experienced caregivers in muscle activity and perceived exertion while repositioning bedridden patients.

    Science.gov (United States)

    Daikoku, Rie; Saito, Yayoi

    2008-11-01

    The aim of this study was to investigate the impact of caregiver knowledge and experience on muscle activity and perceived exertion while repositioning bedridden patients. Subjects were 40- to 65-year-old female caregivers divided into novice and experienced groups. Subjects from both groups performed home-care repositioning techniques on bedridden patients while muscle activity was recorded via electromyogram. Recordings were made from four muscles on the subjects' dominant side: the latissimus dorsi, the biceps brachii, the erector spinae, and the rectus femoris. The subjective burden involved in repositioning was also assessed using the rate of perceived exertion (RPE) and visual analog scales (VAS). Rectus femoris percentage of maximum voluntary contraction (%MVC) values were significantly lower than latissimus dorsi, erector spinae, and biceps brachii values in the novice group. %MVC values from the latissimus dorsi and biceps brachii were significantly higher among the novice group compared to the experienced group. RPE ratings from the novice group were significantly higher than those of the experienced group, and there was a non-significant trend for higher VAS values for the low back, arms, and legs in the novice group compared to the experienced group. Novice caregivers tended to change the patient's position by pulling with the upper limbs without using the lower limbs. In contrast, experienced caregivers exerted less energy by communicating with the patient and utilizing the patient's own movements. They used large, distributed muscle groups that effectively harnessed body mechanics and prevented excess exertion.

  2. Augmented reality in a tumor resection model.

    Science.gov (United States)

    Chauvet, Pauline; Collins, Toby; Debize, Clement; Novais-Gameiro, Lorraine; Pereira, Bruno; Bartoli, Adrien; Canis, Michel; Bourdel, Nicolas

    2018-03-01

    Augmented Reality (AR) guidance is a technology that allows a surgeon to see sub-surface structures, by overlaying pre-operative imaging data on a live laparoscopic video. Our objectives were to evaluate a state-of-the-art AR guidance system in a tumor surgical resection model, comparing the accuracy of the resection with and without the system. Our system has three phases. Phase 1: using the MRI images, the kidney's and pseudotumor's surfaces are segmented to construct a 3D model. Phase 2: the intra-operative 3D model of the kidney is computed. Phase 3: the pre-operative and intra-operative models are registered, and the laparoscopic view is augmented with the pre-operative data. We performed a prospective experimental study on ex vivo porcine kidneys. Alginate was injected into the parenchyma to create pseudotumors measuring 4-10 mm. The kidneys were then analyzed by MRI. Next, the kidneys were placed into pelvictrainers, and the pseudotumors were laparoscopically resected. The AR guidance system allows the surgeon to see tumors and margins using classical laparoscopic instruments, and a classical screen. The resection margins were measured microscopically to evaluate the accuracy of resection. Ninety tumors were segmented: 28 were used to optimize the AR software, and 62 were used to randomly compare surgical resection: 29 tumors were resected using AR and 33 without AR. The analysis of our pathological results showed 4 failures (tumor with positive margins) (13.8%) in the AR group, and 10 (30.3%) in the Non-AR group. There was no complete miss in the AR group, while there were 4 complete misses in the non-AR group. In total, 14 (42.4%) tumors were completely missed or had a positive margin in the non-AR group. Our AR system enhances the accuracy of surgical resection, particularly for small tumors. Crucial information such as resection margins and vascularization could also be displayed.

  3. Robotic liver surgery: results for 70 resections.

    Science.gov (United States)

    Giulianotti, Pier Cristoforo; Coratti, Andrea; Sbrana, Fabio; Addeo, Pietro; Bianco, Francesco Maria; Buchs, Nicolas Christian; Annechiarico, Mario; Benedetti, Enrico

    2011-01-01

    Robotic surgery is gaining popularity for digestive surgery; however, its use for liver surgery is reported scarcely. This article reviews a surgeon's experience with the use of robotic surgery for liver resections. From March 2002 to March 2009, 70 robotic liver resections were performed at 2 different centers by a single surgeon. The surgical procedure and postoperative outcome data were reviewed retrospectively. Malignant tumors were indications for resections in 42 (60%) patients, whereas benign tumors were indications in 28 (40%) patients. The median age was 60 years (range, 21-84) and 57% of patients were female. Major liver resections (≥ 3 liver segments) were performed in 27 (38.5%) patients. There were 4 conversions to open surgery (5.7%). The median operative time for a major resection was 313 min (range, 220-480) and 198 min (range, 90-459) for minor resection. The median blood loss was 150 mL (range, 20-1,800) for minor resection and 300 mL (range, 100-2,000) for major resection. The mortality rate was 0%, and the overall rate of complications was 21%. Major morbidity occurred in 4 patients in the major hepatectomies group (14.8%) and in 4 patients in the minor hepatectomies group (9.3%). All complications were managed conservatively and none required reoperation. This preliminary experience shows that robotic surgery can be used safely for liver resections with a limited conversion rate, blood loss, and postoperative morbidity. Robotics offers a new technical option for minimally invasive liver surgery. Copyright © 2011 Mosby, Inc. All rights reserved.

  4. Estimating Co-Contraction Activation of Trunk Muscles Using a Novel Musculoskeletal Model for Pregnant Women

    Directory of Open Access Journals (Sweden)

    Saori Morino

    2017-10-01

    Full Text Available Weight gain and stretched abdominal muscles from an enlarged gravid uterus are remarkable features during pregnancy. These changes elicit postural instability and place strain on body segments, contributing to lower back pain. In general, the agonist and antagonist muscles act simultaneously to increase joint stabilization; however, this can cause additional muscle stress during movement. Furthermore, this activation can be observed in pregnant women because of their unstable body joints. Hence, physical modalities based on assessments of muscle activation are useful for managing low back pain during pregnancy. Musculoskeletal models are common when investigating muscle load. However, it is difficult to apply such models to pregnant women and estimate the co-contraction of muscles using musculoskeletal models. Therefore, the purpose of this study is to construct a musculoskeletal model for pregnant women that estimates the co-contraction of trunk muscles. First, motion analysis was conducted on a pregnant woman and the muscle activations of the rectus abdominis and erector spinae were measured. Then, the musculoskeletal model was specifically modified for pregnant women. Finally, the co-contraction was estimated from the results of the musculoskeletal model and electromyography data using a genetic algorithm. With the proposed methods, weakened abdominal muscle torque and the co-contraction activation of trunk muscles were estimated successfully.

  5. Effectiveness of the Wavelet Transform on the Surface EMG to Understand the Muscle Fatigue During Walk

    Science.gov (United States)

    Hussain, M. S.; Mamun, Md.

    2012-01-01

    Muscle fatigue is the decline in ability of a muscle to create force. Electromyography (EMG) is a medical technique for measuring muscle response to nervous stimulation. During a sustained muscle contraction, the power spectrum of the EMG shifts towards lower frequencies. These effects are due to muscle fatigue. Muscle fatigue is often a result of unhealthy work practice. In this research, the effectiveness of the wavelet transform applied to the surface EMG (SEMG) signal as a means of understanding muscle fatigue during walk is presented. Power spectrum and bispectrum analysis on the EMG signal getting from right rectus femoris muscle is executed utilizing various wavelet functions (WFs). It is possible to recognize muscle fatigue appreciably with the proper choice of the WF. The outcome proves that the most momentous changes in the EMG power spectrum are symbolized by WF Daubechies45. Moreover, this research has compared bispectrum properties to the other WFs. To determine muscle fatigue during gait, Daubechies45 is used in this research to analyze the SEMG signal.

  6. Stiffness of individual quadriceps muscle assessed using ultrasound shear wave elastography during passive stretching

    Directory of Open Access Journals (Sweden)

    Jingfei Xu

    2018-04-01

    Full Text Available Background: Until recently it has not been possible to isolate the mechanical behavior of individual muscles during passive stretching. Muscle shear modulus (an index of muscle stiffness measured using ultrasound shear wave elastography can be used to estimate changes in stiffness of an individual muscle. The aims of the present study were (1 to determine the shear modulus–knee angle relationship and the slack angle of the vastus medialis oblique (VMO, rectus femoris (RF, and vastus lateralis (VL muscles; (2 to determine whether this differs between the muscles. Methods: Nine male rowers took part in the study. The shear modulus of VMO, RF, and VL muscles was measured while the quadriceps was passively stretched at 3°/s. The relationship between the muscle shear modulus and knee angle was plotted as shear modulus–knee angle curve through which the slack angle of each muscle was determined. Results: The shear modulus of RF was higher than that of VMO and VL when the muscles were stretched over 54° (all p  0.05. The slack angle was similar among the muscles: 41.3° ± 10.6°, 44.3° ± 9.1°, and 44.3° ± 5.6° of knee flexion for VMO, RF, and VL, respectively (p = 0.626. Conclusion: This is the first study to experimentally determine the muscle mechanical behavior of individual heads of the quadriceps during passive stretching. Different pattern of passive tension was observed between mono- and bi-articular muscles. Further research is needed to determine whether changes in muscle stiffness are muscle-specific in pathological conditions or after interventions such as stretching protocols. Keywords: Muscle tension, Optimal length, Shear modulus, Slack angle, Stretch, Ultrasonography, Vastus lateralis, Vastus medialis

  7. Endoscopic full-thickness resection: Current status.

    Science.gov (United States)

    Schmidt, Arthur; Meier, Benjamin; Caca, Karel

    2015-08-21

    Conventional endoscopic resection techniques such as endoscopic mucosal resection or endoscopic submucosal dissection are powerful tools for treatment of gastrointestinal neoplasms. However, those techniques are restricted to superficial layers of the gastrointestinal wall. Endoscopic full-thickness resection (EFTR) is an evolving technique, which is just about to enter clinical routine. It is not only a powerful tool for diagnostic tissue acquisition but also has the potential to spare surgical therapy in selected patients. This review will give an overview about current EFTR techniques and devices.

  8. Muscle MRI in neutral lipid storage disease with myopathy carrying mutation c.187+1G>A.

    Science.gov (United States)

    Xu, Chunxiao; Zhao, Yawen; Liu, Jing; Zhang, Wei; Wang, Zhaoxia; Yuan, Yun

    2015-06-01

    We describe the clinical and muscle MRI changes in 2 siblings with neutral lipid storage disease with myopathy (NLSDM) carrying the mutation c.187+1G>A. Peripheral blood smears, genetic tests, and muscle biopsies were performed. Thigh MRI was performed to observe fatty replacement, muscle edema, and muscle bulk from axial sections. Both siblings had similar fatty infiltration and edema. T1-weighted images of the gluteus maximus, adductor magnus, semitendinosus, and semimembranosus revealed marked and diffuse fatty infiltration. There was asymmetric involvement in biceps femoris and quadriceps. There was extensive fatty infiltration in the quadriceps, except for the rectus femoris. Gracilis and sartorius were relatively spared. Thigh muscle volume was decreased, while the gracilis and sartorius appeared to show compensatory hypertrophy. Compared with previous reports in NLSDM, MRI changes in this myopathy tended to be more severe. Asymmetry and relatively selective fatty infiltration were characteristics. © 2014 Wiley Periodicals, Inc.

  9. Your Muscles

    Science.gov (United States)

    ... and you need to throw up. The muscles push the food back out of the stomach so it comes up ... body the power it needs to lift and push things. Muscles in your neck and the top part of your back aren't as large, but they are capable ...

  10. CT in the diagnosis of isolated cysticercal infestation of extraocular muscle

    International Nuclear Information System (INIS)

    Rauniyar, R.K.; Thakur, S.K.D.; Panda, A.

    2003-01-01

    AIM: To evaluate the use of computed tomography (CT) and ultrasound (US) to diagnose orbital cysticercosis, and present the diagnostic features. METHOD: US and CT were used to evaluate patients with proptosis. Four patients were diagnosed as having orbital myocysticercosis and treated with oral albendazole and corticosteroid. Follow-up was undertaken with US and CT. RESULT: US features were confirmatory of myocysticercosis in two eyes where as CT was effective in diagnosing the condition in all four eyes. In two patients the medial rectus was involved, in one the superior rectus and, in the other, the inferior rectus muscles. Serial US and CT revealed complete resolution of the lesions in 3 months. CONCLUSION: CT is useful method in diagnosing isolated orbital myocysticercosis. Our report demonstrated that ophthalmic signs and symptoms in the presence of proptosis, especially in an endemic region, should alert the clinician to the possibility of myocysticercosis. Though CT is superior, US can be used as a economical follow-up investigation. Rauniyar, R. K. etal. (2003) Clinical Radiology58, 154--156

  11. CT in the diagnosis of isolated cysticercal infestation of extraocular muscle

    Energy Technology Data Exchange (ETDEWEB)

    Rauniyar, R.K.; Thakur, S.K.D.; Panda, A

    2003-02-01

    AIM: To evaluate the use of computed tomography (CT) and ultrasound (US) to diagnose orbital cysticercosis, and present the diagnostic features. METHOD: US and CT were used to evaluate patients with proptosis. Four patients were diagnosed as having orbital myocysticercosis and treated with oral albendazole and corticosteroid. Follow-up was undertaken with US and CT. RESULT: US features were confirmatory of myocysticercosis in two eyes where as CT was effective in diagnosing the condition in all four eyes. In two patients the medial rectus was involved, in one the superior rectus and, in the other, the inferior rectus muscles. Serial US and CT revealed complete resolution of the lesions in 3 months. CONCLUSION: CT is useful method in diagnosing isolated orbital myocysticercosis. Our report demonstrated that ophthalmic signs and symptoms in the presence of proptosis, especially in an endemic region, should alert the clinician to the possibility of myocysticercosis. Though CT is superior, US can be used as a economical follow-up investigation. Rauniyar, R. K. etal. (2003) Clinical Radiology58, 154--156.

  12. Optimizing Adjuvant Therapy for Resected Pancreatic Cancer

    Science.gov (United States)

    In this clinical trial, patients with resected pancreatic head cancer will be randomly assigned to receive either gemcitabine with or without erlotinib for 5 treatment cycles. Patients who do not experience disease progression or recurrence will then be r

  13. ACR Appropriateness Criteria on Resectable Rectal Cancer

    International Nuclear Information System (INIS)

    Suh, W. Warren; Blackstock, A. William; Herman, Joseph; Konski, Andre A.; Mohiuddin, Mohammed; Poggi, Matthew M.; Regine, William F.; Cosman, Bard C.; Saltz, Leonard; Johnstone, Peter A.S.

    2008-01-01

    The American College of Radiology (ACR) Appropriateness Criteria on Resectable Rectal Cancer was updated by the Expert Panel on Radiation Oncology-Rectal/Anal Cancer, based on a literature review completed in 2007

  14. Open resections for congenital lung malformations

    Directory of Open Access Journals (Sweden)

    Mullassery Dhanya

    2008-01-01

    Full Text Available Aim: Pediatric lung resection is a relatively uncommon procedure that is usually performed for congenital lesions. In recent years, thoracoscopic resection has become increasingly popular, particularly for small peripheral lesions. The aim of this study was to review our experience with traditional open lung resection in order to evaluate the existing "gold standard." Materials and Methods: We carried out a retrospective analysis of all children having lung resection for congenital lesions at our institution between 1997 and 2004. Data were collected from analysis of case notes, operative records and clinical consultation. The mean follow-up was 37.95 months. The data were analyzed using SPSS. Results: Forty-one children (13 F/28 M underwent major lung resections during the study period. Their median age was 4.66 months (1 day-9 years. The resected lesions included 21 congenital cystic adenomatoid malformations, 14 congenital lobar emphysema, four sequestrations and one bronchogenic cyst. Fifty percent of the lesions were diagnosed antenatally. Twenty-six patients had a complete lobectomy while 15 patients had parenchymal sparing resection of the lesion alone. Mean postoperative stay was 5.7 days. There have been no complications in any of the patients. All patients are currently alive, asymptomatic and well. None of the patients have any significant chest deformity. Conclusions: We conclude that open lung resection enables parenchymal sparing surgery, is versatile, has few complications and produces very good long-term results. It remains the "gold standard" against which minimally invasive techniques may be judged.

  15. Robotic vascular resections during Whipple procedure

    OpenAIRE

    Allan, Bassan J.; Novak, Stephanie M.; Hogg, Melissa E.; Zeh, Herbert J.

    2018-01-01

    Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vas...

  16. Morphometrical differences between resectable and non-resectable pancreatic cancer: a fractal analysis.

    Science.gov (United States)

    Vasilescu, Catalin; Giza, Dana Elena; Petrisor, Petre; Dobrescu, Radu; Popescu, Irinel; Herlea, Vlad

    2012-01-01

    Pancreatic cancer is a highly aggressive cancer with a rising incidence and poor prognosis despite active surgical treatment. Candidates for surgical resection should be carefully selected. In order to avoid unnecessary laparotomy it is useful to identify reliable factors that may predict resectability. Nuclear morphometry and fractal dimension of pancreatic nuclear features could provide important preoperative information in assessing pancreas resectability. Sixty-one patients diagnosed with pancreatic cancer were enrolled in this retrospective study between 2003 and 2005. Patients were divided into two groups: one resectable cancer group and one with non-resectable pancreatic cancer. Morphometric parameters measured were: nuclear area, length of minor axis and length of major axis. Nuclear shape and chromatin distribution of the pancreatic tumor cells were both estimated using fractal dimension. Morphometric measurements have shown significant differences between the nuclear area of the resectable group and the non-resectable group (61.9 ± 19.8µm vs. 42.2 ± 15.6µm). Fractal dimension of the nuclear outlines and chromatin distribution was found to have a higher value in the non-resectable group (p<0.05). Objective measurements should be performed to improve risk assessment and therapeutic decisions in pancreatic cancer. Nuclear morphometry of the pancreatic nuclear features can provide important pre-operative information in resectability assessment. The fractal dimension of the nuclear shape and chromatin distribution may be considered a new promising adjunctive tool for conventional pathological analysis.

  17. Effects of strength training, detraining and retraining in muscle strength, hypertrophy and functional tasks in older female adults.

    Science.gov (United States)

    Correa, Cleiton S; Cunha, Giovani; Marques, Nise; Oliveira-Reischak, Ãlvaro; Pinto, Ronei

    2016-07-01

    Previous studies presented different results regarding the maintenance time of muscular adaptations after strength training and the ability to resume the gains on muscular performance after resumption of the training programme. This study aimed to verify the effect of strength training on knee extensors and elbow flexor muscle strength, rectus femoris muscle volume and functional performance in older female adults after 12 weeks of strength training, 1 year of detraining and followed by 12 weeks of retraining. Twelve sedentary older women performed 12 weeks of strength training, 1 year of detraining and 12 weeks of retraining. The strength training was performed twice a week, and the assessment was made four times: at the baseline, after the strength training, after the detraining and after the retraining. The knee extensor and elbow flexor strength, rectus femoris muscle volume and functional task were assessed. Strength of knee extensor and elbow flexor muscles, rectus femoris muscle volume and 30-s sit-to-stand increased from baseline to post-training (respectively, 40%, 70%, 38% and 46%), decreased after detraining (respectively, -36%, -64%, -35% and -43%) and increased again these parameters after retraining (35%, 68%, 36% and 42%). Strength training induces gains on strength and hypertrophy, also increased the performance on functional tasks after the strength training. The stoppage of the strength caused strength loss and reduction of functional performance. The resumption of the strength training promoted the same gains of muscular performance in older female adults. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  18. A pilot study on the influence of exercising on unstable training machine on balance control and trunk muscles activity.

    Science.gov (United States)

    Domeika, Aurelijus; Aleknaite-Dambrauskiene, Ieva; Poskaitis, Vytautas; Zaveckas, Vidmantas; Grigas, Vytautas; Zvironiene, Ausra

    2018-05-16

    The main position of the working population is becoming sitting. Immobile prolonged sedentary time may cause negative effects including reduced intervertebral discs nutrition. Main ways of mitigating them are regular position changes and exercising. To evaluate influence of the short term training on unstable training machine on balance control and trunk muscles activity in patients with lower back pain. Participants (n=16) experiencing lower back pain were trained on an unstable sculling machine "Rehabili". Their balance tested by (Biodex Balance System) and rectus abdominis, externus oblique, transverse abdominis, multifidus and erector spine muscles activity (measured by surface electromyography) while sitting and standing with usual and aligned body postures both before and after six weeks of training (three 15 minutes sessions per week) were compared in between. Balance control improved after the training program. Besides, more symmetrical activation of both sides rectus and transversus abdominis muscles, as well as increased transversus abdominis muscle activation of 19% (p< 0.05), were observed. Six weeks short sessions training on unstable training machine improved balance control and increased trunk muscles activity especially in aligned body posture when standing or sitting on unstable surface.

  19. Role of Smooth Muscle in Intestinal Inflammation

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    Stephen M Collins

    1996-01-01

    Full Text Available The notion that smooth muscle function is altered in inflammation is prompted by clinical observations of altered motility in patients with inflammatory bowel disease (IBD. While altered motility may reflect inflammation-induced changes in intrinsic or extrinsic nerves to the gut, changes in gut hormone release and changes in muscle function, recent studies have provided in vitro evidence of altered muscle contractility in muscle resected from patients with ulcerative colitis or Crohn’s disease. In addition, the observation that smooth muscle cells are more numerous and prominent in the strictured bowel of IBD patients compared with controls suggests that inflammation may alter the growth of intestinal smooth muscle. Thus, inflammation is associated with changes in smooth muscle growth and contractility that, in turn, contribute to important symptoms of IBD including diarrhea (from altered motility and pain (via either altered motility or stricture formation. The involvement of smooth muscle in this context may be as an innocent bystander, where cells and products of the inflammatory process induce alterations in muscle contractility and growth. However, it is likely that intestinal muscle cells play a more active role in the inflammatory process via the elaboration of mediators and trophic factors, including cytokines, and via the production of collagen. The concept of muscle cells as active participants in the intestinal inflammatory process is a new concept that is under intense study. This report summarizes current knowledge as it relates to these two aspects of altered muscle function (growth and contractility in the inflamed intestine, and will focus on mechanisms underlying these changes, based on data obtained from animal models of intestinal inflammation.

  20. Fibrose congênita de reto inferior atípica com hipotonia muscular generalizada: relato de um caso Atipical inferior rectus congenital fibrosis with generalizated muscular hypotonia: case report

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    Ezon Vinicius Alves Pinto Ferraz

    1999-10-01

    Full Text Available O caso descrito apresentava uma hipotropia pouco severa com acuidade visual normal e binocularidade em infra-versão; além de uma hipotonia muscular generalizada, ao contrário da severa hipotropia e ambliopia encontrada nessa afecção. O procedimento cirúrgico levou estes fatos em consideração, tendo-se optado por um retrocesso pequeno do reto inferior para que se corrigisse o torcicolo sem interferir na posição de leitura. Os resultados pós-operatórios foram satisfatórios.A case report of an atipical inferior rectus congenital fibrosis associated with a generalized muscular hypotonia is presented. It shows mild hipotropia with a normal visual acuity and binocularity in infraversion position contrasting with the severe hipotropia and ambliopy found. The surgical procedure took these facts into consideration, so we performed a small retrocess of the muscle with the objective to correct the head position without changes in the reading position. The postoperative results were satisfactory.

  1. CHANGES IN QUADRICEPS MUSCLE ACTIVITY DURING SUSTAINED RECREATIONAL ALPINE SKIING

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    Josef Kröll

    2011-03-01

    Full Text Available During a day of skiing thousands of repeated contractions take place. Previous research on prolonged recreational alpine skiing show that physiological changes occur and hence some level of fatigue is inevitable. In the present paper the effect of prolonged skiing on the recruitment and coordination of the muscle activity was investigated. Six subjects performed 24 standardized runs. Muscle activity during the first two (PREskiing and the last two (POSTskiing runs was measured from the vastus lateralis (VL and rectus femoris (RF using EMG and quantified using wavelet and principal component analysis. The frequency content of the EMG signal shifted in seven out of eight cases significantly towards lower frequencies with highest effects observed for RF on outside leg. A significant pronounced outside leg loading occurred during POSTskiing and the timing of muscle activity peaks occurred more towards turn completion. Specific EMG frequency changes were observed at certain time points throughout the time windows and not over the whole double turn. It is suggested that general muscular fatigue, where additional specific muscle fibers have to be recruited due to the reduced power output of other fibers did not occur. The EMG frequency decrease and intensity changes for RF and VL are caused by altered timing (coordination within the turn towards a most likely more uncontrolled skiing technique. Hence, these data provide evidence to suggest recreational skiers alter their skiing technique before a potential change in muscle fiber recruitment occurs

  2. Activity of Lower Limb Muscles During Squat With and Without Abdominal Drawing-in and Pilates Breathing.

    Science.gov (United States)

    Barbosa, Alexandre C; Martins, Fábio M; Silva, Angélica F; Coelho, Ana C; Intelangelo, Leonardo; Vieira, Edgar R

    2017-11-01

    Barbosa, AC, Martins, FM, Silva, AF, Coelho, AC, Intelangelo, L, and Vieira, ER. Activity of lower limb muscles during squat with and without abdominal drawing-in and Pilates breathing. J Strength Cond Res 31(11): 3018-3023, 2017-The purpose of this study was to assess the effects of abdominal drawing-in and Pilates breathing on the activity of lower limb muscles during squats. Adults (n = 13, 22 ± 3 years old) with some Pilates experience performed three 60° squats under each of the following conditions in a random order: (I) normal breathing, (II) drawing-in maneuver with normal breathing, and (III) drawing-in maneuver with Pilates breathing. Peak-normalized surface electromyography of the rectus femoris, biceps femoris, gastrocnemius medialis, and tibialis anterior during the knee flexion and extension phases of squat exercises was analyzed. There were significant differences among the conditions during the knee flexion phase for the rectus femoris (p = 0.001), biceps femoris (p = 0.038), and tibialis anterior (p = 0.001), with increasing activation from conditions I to III. For the gastrocnemius medialis, there were significant differences among the conditions during the knee extension phase (p = 0.023), with increased activity under condition I. The rectus and biceps femoris activity was higher during the extension vs. flexion phase under conditions I and II. The tibialis anterior activity was higher during the flexion compared with the extension phase under all conditions, and the medial gastrocnemius activity was higher during the extension phase under condition I. Doing squats with abdominal drawing-in and Pilates breathing resulted in increased rectus, biceps femoris, and tibialis anterior activity during the flexion phase, increasing movement stability during squat exercises.

  3. Re-exploration of vertical rectus abdominis myocutaneous flap for vaginal reconstruction: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Joshua D. Rouch

    2018-03-01

    Full Text Available The vertical rectus abdominis myocutaneous (VRAM flap is a versatile and well-established reconstructive technique for many defects created as a result of colorectal and gynecologic extirpation. However, major re-operation in the pelvis following a VRAM flap reconstruction several months later is uncommon, and the safety and integrity of the VRAM flap in this setting has not been described. This case examines VRAM flap preservation during repeat exploratory laparotomy, and a unique view of the VRAM flap during interval exploration. We demonstrate an intact flap after lysis of adhesions with an audible Doppler signal, and maintenance of flap integrity in the postoperative period. This further substantiates its use as a durable rotational flap for perineal tissue defects.

  4. Muscle cramps

    Science.gov (United States)

    ... the lower leg/calf Back of the thigh (hamstrings) Front of the thigh (quadriceps) Cramps in the ... Names Cramps - muscle Images Chest stretch Groin stretch Hamstring stretch Hip stretch Thigh stretch Triceps stretch References ...

  5. Muscle atrophy

    Science.gov (United States)

    ... People who cannot actively move one or more joints can do exercises using braces or splints . When ... A.M. Editorial team. Muscle Disorders Read more Neuromuscular Disorders Read more NIH MedlinePlus Magazine Read more ...

  6. Transcallosal, Transchoroidal Resection of a Recurrent Craniopharyngioma.

    Science.gov (United States)

    Jean, Walter C

    2018-04-01

    Objective  To demonstrate the transchoroidal approach for the resection of a recurrent craniopharyngioma. Design  Video case report. Setting  Microsurgical resection. Participant  The patient was a 27-year-old woman with a history of a craniopharyngioma, resected twice during the year prior to presentation to our unit. Both operations were done via the left anterolateral corridor, and afterward, she was blind in the left eye and was treated with Desmopressin (DDAVP) for diabetes insipidus (DI). Serial magnetic resonance imaging (MRI) showed progression of the tumor residual, and she was referred for further surgical intervention. Main Outcome Measures  Pre- and postoperative MRIs measured the degree of resection. Results  For this, her third surgery, a transcallosal, transchoroidal approach, was chosen to offer the widest possible exposure. Given her history, an aggressive total resection was the best strategy. The patient was placed supine with the head neutral. A right frontal craniotomy allowed access to the interhemispheric fissure. By opening the corpus callosum, the left lateral ventricle was entered. The transchoroidal approach started with dissection of the tenia fornicis to open the choroidal fissure. After this, sufficient exposure to the posterior parts of the tumor was gained. Resection proceeded to the bottom of the tumor, exposing the basilar apex and interpeduncular cistern, and continued back anteriorly. In the end, a microscopic total resection was achieved. With a long hospital stay to treat her brittle DI, the patient slowly returned to neurological baseline. Conclusion  The transchoroidal approach is an effective way to remove large tumors in the third ventricle. The link to the video can be found at: https://youtu.be/2-Aqjaay8dg .

  7. Evaluation of surgeon's muscle fatigue during thoracoscopic pulmonary lobectomy using interoperative surface electromyography.

    Science.gov (United States)

    Yoon, Seung-Hyun; Jung, Myung-Chul; Park, Seong Yong

    2016-06-01

    The aim of this study was to document the physical stress experienced by a surgeon during thoracoscopic pulmonary lobectomy and mediastinal lymph node dissection for lung cancer by measuring the intraoperative electromyography (EMG). Surface EMG was recorded during 12 cases of thoracoscopic lobectomy. During the operation, 16 channels of a wireless EMG were used to measure muscle activity and fatigue from the bilateral muscles of the splenius capitis (SC), upper trapezius (UT), middle deltoid (MD), flexor carpi radialis (FCR), extensor carpi radialis (ECR), lumbar erector spinae (LES), rectus femoralis (RF), and tibialis anterior (TA). The EMG signals were processed to collect the values of the root mean square for muscle activity and median frequency (MF) for muscle fatigue. All operations were completed without adverse events. The mean operating time was 99.16±35.15 minutes. During the operation, the mean muscle activity of all muscles was 21.91±12.85 mV. High muscle activity was observed in the bilateral FCR and ECR, whereas low muscle activity was observed in the bilateral SC and LES. The final MFs in the bilateral SC and LES were found to be decreased from the initial status, which implied increased muscle fatigue. The muscles of the right and left LES were significantly fatigued by up to 29% and 37% compared to their initial status (P=0.021 and P=0.007, respectively). The MFs of the bilateral LES decreased with time (an average decreases of 0.008/5 minutes, P=0.002 in right LES and 0.004/5 minutes, P=0.018 in left LES). During thoracoscopic lobectomy, muscle fatigue was observed in muscles related to a static posture, such as the bilateral SC, UT, and ES. Further studies are required to investigate the ergonomic adjustments needed to reduce muscle fatigue in these static muscles.

  8. Electromechanical delay of abdominal muscles is modified by low back pain prevention exercise.

    Science.gov (United States)

    Szpala, Agnieszka; Rutkowska-Kucharska, Alicja; Drapala, Jaroslaw

    2014-01-01

    The objective of the research was to assess the effect of a 4-week-long training program on selected parameters: electromechanical delay (EMD) and amplitude of electromyographic signal (EMG). Fourteen female students of the University School of Physical Education participated in the study. Torques and surface electromyography were evaluated under static conditions. Surface electrodes were glued to both sides of the rectus abdominis (RA), external oblique (EO), and erector spinae (ES) muscles. The 4-week-long program was aimed at strengthening the abdominal muscles and resulted in increased EMD during maximum torque production by flexors of the trunk, increased amplitudes of the signals of the erector spinae ( p = 0.005), and increased EMG amplitude asymmetry of the lower ( p = 0.013) and upper part ( p = 0.006) of the rectus abdominis muscle. In a training program composed of a large number of repetitions of strength exercises, in which the training person uses their own weight as the load (like in exercises such as curl-ups), the process of recruitment of motor units is similar to that found during fatiguing exercises and plyometric training.

  9. Transcanal endoscopic resection for leiomyoma of the external auditory canal and a review of the literature.

    Science.gov (United States)

    Ikeda, Ryoukichi; Tateda, Masaru; Okoshi, Akira; Morita, Shinkichi; Suzuki, Hiroyoshi; Hashimoto, Sho

    2016-02-01

    Leiomyoma usually originates from the uterus and alimentary tract, but in extremely rare cases leiomyoma can appear in the external auditory canal. Here we present a 37-year-old man with right auricular fullness. Preoperative findings suggested benign tumor or cholesteatoma in the right external auditory canal. We performed total resection using an endoauricular approach with transcanal endoscopic ear surgery. Histopathological and immunohistochemistry examination confirmed the diagnosis of leiomyoma of external auditory canal. Leiomyoma arising from soft tissue, including that in the external auditory canal, is classified into two types: that from the arrectores pilorum muscles and that from the muscle coats of blood vessels. Only four cases of leiomyoma of external auditor canal have been published in the English literature. The other four cases demonstrated vascular leiomyomas. This is the first report of leiomyoma of the EAC arising from arrectores pilorum muscles. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Abdominal muscle activity during a standing long jump.

    Science.gov (United States)

    Okubo, Yu; Kaneoka, Koji; Shiina, Itsuo; Tatsumura, Masaki; Miyakawa, Shumpei

    2013-08-01

    Experimental laboratory study. To measure the activation patterns (onset and magnitude) of the abdominal muscles during a standing long jump using wire and surface electromyography. Activation patterns of the abdominal muscles, especially the deep muscles such as the transversus abdominis (TrA), have yet to be examined during full-body movements such as jumping. Thirteen healthy men participated. Wire electrodes were inserted into the TrA with the guidance of ultrasonography, and surface electrodes were attached to the skin overlying the rectus abdominis (RA) and external oblique (EO). Electromyographic signals and video images were recorded while each subject performed a standing long jump. The jump task was divided into 3 phases: preparation, push-off, and float. For each muscle, activation onset relative to the onset of the RA and normalized muscle activation levels (percent maximum voluntary contraction) were analyzed during each phase. Comparisons between muscles and phases were assessed using 2-way analyses of variance. The onset times of the TrA and EO relative to the onset of the RA were -0.13 ? 0.17 seconds and -0.02 ? 0.07 seconds, respectively. Onset of TrA activation was earlier than that of the EO. The activation levels of all 3 muscles were significantly greater during the push-off phase than during the preparation and float phases. Consistent with previously published trunk-perturbation studies in healthy persons, the TrA was activated prior to the RA and EO. Additionally, the highest muscle activation levels were observed during the push-off phase.

  11. MDCT assessment of resectability in hilar cholangiocarcinoma.

    Science.gov (United States)

    Ni, Qihong; Wang, Haolu; Zhang, Yunhe; Qian, Lijun; Chi, Jiachang; Liang, Xiaowen; Chen, Tao; Wang, Jian

    2017-03-01

    The purpose of this study is to investigate the value of multidetector computed tomography (MDCT) assessment of resectability in hilar cholangiocarcinoma, and to identify the factors associated with unresectability and accurate evaluation of resectability. From January 2007 to June 2015, a total of 77 consecutive patients were included. All patients had preoperative MDCT (with MPR and MinIP) and surgical treatment, and were pathologically proven with hilar cholangiocarcinoma. The MDCT images were reviewed retrospectively by two senior radiologists and one hepatobiliary surgeon. The surgical findings and pathologic results were considered to be the gold standard. The Chi square test was used to identify factors associated with unresectability and accurate evaluation of resectability. The sensitivity, specificity, and overall accuracy of MDCT assessment were 83.3 %, 75.9 %, and 80.5 %, respectively. The main causes of inaccuracy were incorrect evaluation of N2 lymph node metastasis (4/15) and distant metastasis (4/15). Bismuth type IV tumor, main or bilateral hepatic artery involvement, and main or bilateral portal vein involvement were highly associated with unresectability (P hilar cholangiocarcinoma. Bismuth type IV tumor and main or bilateral vascular involvement highly suggest the unresectability of hilar cholangiocarcinoma. Patients without biliary drainage have a more accurate MDCT evaluation of resectability. We suggest MDCT should be performed before biliary drainage to achieve an accurate evaluation of resectability in hilar cholangiocarcinoma.

  12. Vertebral Column Resection for Rigid Spinal Deformity.

    Science.gov (United States)

    Saifi, Comron; Laratta, Joseph L; Petridis, Petros; Shillingford, Jamal N; Lehman, Ronald A; Lenke, Lawrence G

    2017-05-01

    Broad narrative review. To review the evolution, operative technique, outcomes, and complications associated with posterior vertebral column resection. A literature review of posterior vertebral column resection was performed. The authors' surgical technique is outlined in detail. The authors' experience and the literature regarding vertebral column resection are discussed at length. Treatment of severe, rigid coronal and/or sagittal malalignment with posterior vertebral column resection results in approximately 50-70% correction depending on the type of deformity. Surgical site infection rates range from 2.9% to 9.7%. Transient and permanent neurologic injury rates range from 0% to 13.8% and 0% to 6.3%, respectively. Although there are significant variations in EBL throughout the literature, it can be minimized by utilizing tranexamic acid intraoperatively. The ability to correct a rigid deformity in the spine relies on osteotomies. Each osteotomy is associated with a particular magnitude of correction at a single level. Posterior vertebral column resection is the most powerful posterior osteotomy method providing a successful correction of fixed complex deformities. Despite meticulous surgical technique and precision, this robust osteotomy technique can be associated with significant morbidity even in the most experienced hands.

  13. Murine Ileocolic Bowel Resection with Primary Anastomosis

    Science.gov (United States)

    Perry, Troy; Borowiec, Anna; Dicken, Bryan; Fedorak, Richard; Madsen, Karen

    2014-01-01

    Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn’s disease and colon cancer being two common examples. Despite the frequency of these procedures, a significant knowledge gap remains in describing the inherent effects of intestinal resection on host physiology and disease pathophysiology. This article provides detailed instructions for an ileocolic resection with primary end-to-end anastomosis in mice, as well as essential aspects of peri-operative care to maximize post-operative success. When followed closely, this procedure yields a 95% long-term survival rate, no failure to thrive, and minimizes post-operative complications of bowel obstruction and anastomotic leak. The technical challenges of performing the procedure in mice are a barrier to its wide spread use in research. The skills described in this article can be acquired without previous surgical experience. Once mastered, the murine ileocolic resection procedure will provide a reproducible tool for studying the effects of intestinal resection in models of human disease. PMID:25406841

  14. Resection for secondary malignancy of the pancreas.

    Science.gov (United States)

    Hung, Jui-Hsia; Wang, Shin-E; Shyr, Yi-Ming; Su, Cheng-Hsi; Chen, Tien-Hua; Wu, Chew-Wun

    2012-01-01

    This study tried to clarify the role of pancreatic resection in the treatment of secondary malignancy with metastasis or local invasion to the pancreas in terms of surgical risk and survival benefit. Data of secondary malignancy of the pancreas from our 19 patients and cases reported in the English literature were pooled together for analysis. There were 329 cases of resected secondary malignancy of the pancreas, including 241 cases of metastasis and 88 cases of local invasion. The most common primary tumor metastatic to the pancreas and amenable to resection was renal cell carcinoma (RCC) (73.9%). More than half (52.3%) of the primary cancers with local invasion to the pancreas were colon cancer, and nearly half (40.9%) were stomach cancer. The median metastatic interval was 84 months (7 years) for overall primary tumors and 108 months (9 years) for RCC. The 5-year survival for secondary malignancy of the pancreas after resection was 61.1% for metastasis and 58.9% for local invasion, with 72.8% for RCC metastasis, 69.0% for colon cancer, and 43.8% for stomach cancer with local invasion to the pancreas. Pancreatic resection should not be precluded for secondary malignancy of the pancreas because long-term survival could be achieved with acceptable surgical risk in selected patients.

  15. Treatment of tailgut cysts by extended distal rectal segmental resection with rectoanal anastomosis.

    Science.gov (United States)

    Volk, Andreas; Plodeck, Verena; Toma, Marieta; Saeger, Hans-Detlev; Pistorius, Steffen

    2017-04-01

    Complete surgical resection is the treatment of choice for tailgut cysts, because of their malignant potential and tendency to regrow if incompletely resected. We report our experience of treating patients with tailgut cysts, and discuss diagnostics, surgical approaches, and follow-up. We performed extended distal rectal segmental resection of the tailgut cyst, with rectoanal anastomosis. We report the clinical, radiological, pathological, and surgical findings, describe the procedures performed, and summarize follow-up data. Two patients underwent en-bloc resection of a tailgut cyst, the adjacent part of the levator muscle, and the distal rectal segment, followed by an end-to-end rectoanal anastomosis. There was no evidence of anastomotic leakage postoperatively. At the time of writing, our patients were relapse-free with no, or non-limiting, symptoms of anal incontinence, respectively. This surgical approach appears to have a low complication rate and good recovery outcomes. Moreover, as the sphincter is preserved, so is the postoperative anorectal function. This approach could result in a low recurrence rate.

  16. Effects of weight loss and exercise on trunk muscle composition in older women

    Directory of Open Access Journals (Sweden)

    Ryan AS

    2014-03-01

    Full Text Available Alice S Ryan, Aruna Selina Harduarsingh-Permaul Baltimore Veterans Affairs Medical Center; Gerontology and Geriatric Medicine, School of Medicine, University of Maryland; Baltimore Geriatric Research Education and Clinical Center (GRECC, and Research and Development Service, VA Maryland Health Care System, Baltimore, MD, USA Background: Aging and obesity increase the risk for mobility limitations in women. Although trunk muscle composition is important to physical function, the implication of ectopic fat in the trunk muscles with respect to physical fitness and its potential for modification by lifestyle changes is unknown. Methods: The effects of a 6-month period of either weight loss (WL alone or of aerobic exercise (AEX plus WL (AEX+WL, on trunk body composition, as measured by dual-energy X-ray absorptiometry (DXA (to measure trunk fat and lean mass and computed tomography (CT (to measure the erector spinae, psoas, lateral abdominal, rectus abdominis muscle, and intramuscular fat, and the intramuscular adipose tissue [IMAT] areas was determined in 65 overweight and obese postmenopausal women (aged 50-76 years. Results: The area of the erector spinae, psoas, and rectus abdominis muscles declined with age in the women (P<0.05. Both the spinal and abdominal muscle areas were related to the maximal oxygen uptake (VO2max (P<0.05. Body weight decreased by 8% after both AEX+WL and WL (P<0.001. The VO2max increased by 11% after AEX+WL (P<0.001 but did not change with WL alone (group effect, P<0.001. The DXA-measured trunk fat mass decreased by 16% after AEX+WL (P<0.001 and by 12% after WL (P<0.001. When both groups were combined, the IMAT decreased in all four muscle groups - by 6% in the erector spinae (P<0.01, by 9% in the psoas (P<0.01, by 11% in the lateral abdominals (P<0.001, and by 6% in the rectus abdominis (P<0.05. The loss of fat mass was related to the loss of IMAT of the erector spinae and the lateral abdominals. Conclusions: A lifestyle

  17. Cannabinoid CB1 Receptors Are Localized in Striated Muscle Mitochondria and Regulate Mitochondrial Respiration

    Directory of Open Access Journals (Sweden)

    Juan Mendizabal-Zubiaga

    2016-10-01

    Full Text Available The cannabinoid type 1 (CB1 receptor is widely distributed in the brain and peripheral organs where it regulates cellular functions and metabolism. In the brain, CB1 is mainly localized on presynaptic axon terminals but is also found on mitochondria (mtCB1, where it regulates cellular respiration and energy production. Likewise, CB1 is localized on muscle mitochondria, but very little is known about it. The aim of this study was to further investigate in detail the distribution and functional role of mtCB1 in three different striated muscles. Immunoelectron microscopy for CB1 was used in skeletal muscles (gastrocnemius and rectus abdominis and myocardium from wild-type and CB1-KO mice. Functional assessments were performed in mitochondria purified from the heart of the mice and the mitochondrial oxygen consumption upon application of different acute delta-9-tetrahidrocannabinol (Δ9-THC concentrations (100 nM or 200 nM was monitored. About 26% of the mitochondrial profiles in gastrocnemius, 22% in the rectus abdominis and 17% in the myocardium expressed CB1. Furthermore, the proportion of mtCB1 versus total CB1 immunoparticles was about 60% in the gastrocnemius, 55% in the rectus abdominis and 78% in the myocardium. Importantly, the CB1 immunolabeling pattern disappeared in muscles of CB1-KO mice. Functionally, acute 100 nM or 200 nM THC treatment specifically decreased mitochondria coupled respiration between 12% and 15% in wild-type isolated mitochondria of myocardial muscles but no significant difference was noticed between THC treated and vehicle in mitochondria isolated from CB1-KO heart. Furthermore, gene expression of key enzymes involved in pyruvate synthesis, tricarboxylic acid (TCA cycle and mitochondrial respiratory chain was evaluated in the striated muscle of CB1-WT and CB1-KO. CB1-KO showed an increase in the gene expression of Eno3, Pkm2, and Pdha1, suggesting an increased production of pyruvate. In contrast, no significant

  18. Muscle utilization patterns vary by skill levels of the practitioners across specific yoga poses (asanas).

    Science.gov (United States)

    Ni, Meng; Mooney, Kiersten; Balachandran, Anoop; Richards, Luca; Harriell, Kysha; Signorile, Joseph F

    2014-08-01

    To compare muscle activation patterns in 14 dominant side muscles during different yoga poses across three skill levels. Mixed repeated-measures descriptive study. University neuromuscular research laboratory, Miami, US. A group of 36 yoga practitioners (9 M/27 F; mean ± SD, 31.6 ± 12.6 years) with at least 3 months yoga practice experience. Each of the 11 surya namaskar poses A and B was performed separately for 15s and the surface electromyography for 14 muscles were recorded. Normalized root mean square of the electromyographic signal (NrmsEMG) for 14 muscles (5 upper body, 4 trunk, 5 lower body). There were significant main effects of pose for all fourteen muscles except middle trapezius (p<.02) and of skill level for the vastus medialis; p=.027). A significant skill level × pose interaction existed for five muscles (pectoralis major sternal head, anterior deltoid, medial deltoid, upper rectus abdominis and gastrocnemius lateralis; p<.05). Post hoc analyses using Bonferroni comparisons indicated that different poses activated specific muscle groups; however, this varied by skill level. Our results indicate that different poses can produce specific muscle activation patterns which may vary due to practitioners' skill levels. This information can be used in designing rehabilitation and training programs and for cuing during yoga training. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Volume measurement of the horizontal extraocular muscles using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nishida, Yasuhiro; Hayashi, Osamu; Nishida, Eri; Murata, Toyotaka; Aoki, Yoshiko; Inatomi, Akihiro; Kani, Kazutaka (Shiga Univ. of Medical Science, Otsu (Japan)); Mabuchi, Norihisa; Furutani, Yoshiaki

    1993-07-01

    The volume of the horizontal extraocular muscles of 11 normal adults and three patients with ophthalmoplegia was measured using magnetic resonance imaging (MRI). The MRI examinations were carried out with a Signa Advantage, 1.5 tesla superconductive magnetic system manufactured by General Electric. This method employs the spin echo technique with a 3.0 mm gapless slice, a 350 ms. repetition time, and a 17.0 ms. echo time. The MRI films were projected and magnified on Kent paper using an overhead projector. Then the shapes of the horizontal extraocular muscles were traced. The volume of the muscles was measured as the total weight of Kent papers which were cut out from muscle shapes in all the slices. The average volume of the normal medial and lateral rectus muscles was 690[+-]87 mm[sup 3] and 734[+-]77 mm[sup 3], respectively. Two cases of peripheral nerve palsy showed typical atrophy of the paretic muscles. A case of orbital myositis showed typical hypertrophy of the inflamed muscles. This measurement may prove useful in the analysis and evaluation of extraocular muscles, especially in ophthalmoplesia.(author).

  20. Total and regional blood flows in vascularized skeletal muscle grafts in rabbits

    International Nuclear Information System (INIS)

    Burton, H.W.; Stevenson, T.R.; Dysko, R.C.; Gallagher, K.P.; Faulkner, J.A.

    1988-01-01

    The transplantation of whole skeletal muscles is a common clinical procedure. Although atypical blood flows have been reported in small free muscle grafts, the blood flow of large neurovascular-intact (NVI) and neurovascular-anastomosed (NVA) grafts have not been measured. Because the maximum specific force (N/cm 2 ) of NVI and NVA grafts is 65% that of control muscles, we hypothesized that total and regional blood flows of NVI and NVA grafts at rest and during twitch contractions are significantly lower than lower flows of control muscles. In rabbits, blood flows of control rectus femoris (RFM) muscles and NVI and NVA grafts of RFM muscles were measured by the radioactive-microsphere technique. Total blood flows in grafts were not different from the control RFM muscle values, except for a higher resting flow in NVA grafts and a lower flow at 3 Hz in NVI grafts. Minor variations in regional flows were observed. We conclude that the operative procedures of grating and repair of blood vessels affect the vascular bed of muscles minimally, and the deficits observed in grafts do not arise from inadequate perfusion

  1. Neurologic deficit after resection of the sacrum.

    Science.gov (United States)

    Biagini, R; Ruggieri, P; Mercuri, M; Capanna, R; Briccoli, A; Perin, S; Orsini, U; Demitri, S; Arlecchini, S

    1997-01-01

    The authors describe neurologic deficit (sensory, motor, and sphincteral) resulting from sacrifice of the sacral nerve roots removed during resection of the sacrum. The anatomical and functional bases of sphincteral continence and the amount of neurologic deficit are discussed based on level of sacral resection. A large review of the literature on the subject is reported and discussed. The authors emphasize how the neurophysiological bases of sphincteral continence (rectum and bladder) and of sexual ability are still not well known, and how the literature reveals disagreement on the subject. A score system is proposed to evaluate neurologic deficit. The clinical model of neurologic deficit caused by resection of the sacrum may be extended to an evaluation of post-traumatic deficit.

  2. Study of crotoxin on the induction of paralysis in extraocular muscle in animal model

    Directory of Open Access Journals (Sweden)

    Geraldo de Barros Ribeiro

    2012-10-01

    Full Text Available PURPOSE: Crotoxin is the major toxin of the venom of the South American rattlesnake Crotalus durissus terrificus, capable of causing a blockade of the neurotransmitters at the neuromuscular junction. The objective of this study was to appraise the action and effectiveness of the crotoxin induced paralysis of the extraocular muscle and to compare its effects with the botulinum toxin type A (BT-A. METHODS: The crotoxin, with LD50 of 1.5 µg, was injected into the superior rectus muscle in ten New Zealand rabbits. The concentration variance was 0.015 up to 150 µg. Two rabbits received 2 units of botulinum toxin type A for comparative analysis. The evaluation of the paralysis was performed using serial electromyography. After the functional recovery of the muscles, which occurred after two months, six rabbits were sacrificed for anatomopathology study. RESULTS: The animals did not show any evidence of systemic toxicity. Transitory ptosis was observed in almost every animal and remained up to fourteen days. These toxins caused immediate blockade of the electrical potentials. The recovery was gradual in the average of one month with regeneration signs evident on the electromyography. The paralysis effect of the crotoxin on the muscle was proportional to its concentration. The changes with 1.5 µg crotoxin were similar to those produced by the botulinum toxin type A. The histopathology findings were localized to the site of the injection. No signs of muscle fiber's necrosis were seen in any sample. The alterations induced by crotoxin were also proportional to the concentration and similar to botulinum toxin type A in concentration of 1.5 µg. CONCLUSION: Crotoxin was able to induce transitory paralysis of the superior rectus muscle. This effect was characterized by reduction of action potentials and non-specific signs of fibrillation. Crotoxin, in concentration of 1.5 µg was able to induce similar effects as botulinum toxin type A.

  3. Robotic versus laparoscopic resection of liver tumours

    Science.gov (United States)

    Berber, Eren; Akyildiz, Hizir Yakup; Aucejo, Federico; Gunasekaran, Ganesh; Chalikonda, Sricharan; Fung, John

    2010-01-01

    Background There are scant data in the literature regarding the role of robotic liver surgery. The aim of the present study was to develop techniques for robotic liver tumour resection and to draw a comparison with laparoscopic resection. Methods Over a 1-year period, nine patients underwent robotic resection of peripherally located malignant lesions measuring <5 cm. These patients were compared prospectively with 23 patients who underwent laparoscopic resection of similar tumours at the same institution. Statistical analyses were performed using Student's t-test, χ2-test and Kaplan–Meier survival. All data are expressed as mean ± SEM. Results The groups were similar with regards to age, gender and tumour type (P = NS). Tumour size was similar in both groups (robotic −3.2 ± 1.3 cm vs. laparoscopic −2.9 ± 1.3 cm, P = 0.6). Skin-to-skin operative time was 259 ± 28 min in the robotic vs. 234 ± 17 min in the laparoscopic group (P = 0.4). There was no difference between the two groups regarding estimated blood loss (EBL) and resection margin status. Conversion to an open operation was only necessary in one patient in the robotic group. Complications were observed in one patient in the robotic and four patients in the laparoscopic groups. The patients were followed up for a mean of 14 months and disease-free survival (DFS) was equivalent in both groups (P = 0.6). Conclusion The results of this initial study suggest that, for selected liver lesions, a robotic approach provides similar peri-operative outcomes compared with laparoscopic liver resection (LLR). PMID:20887327

  4. Hepatic resection and regeneration. Past and present

    International Nuclear Information System (INIS)

    Hatsuse, Kazuo

    2007-01-01

    Hepatic surgery has been performed on condition that the liver regenerates after hepatic resection, and the development of liver anatomy due to Glisson, Rex, and Couinaud has thrown light on hepatic surgery Understanding of feeding and drainage vessels became feasible for systemic hepatic resection; however, it seems to have been the most important problem to control the bleeding during hepatic resection. New types of devices such as cavitron ultrasonic surgical aspirator (CUSA) and Microwave coagulation were exploited to control blood loss during hepatic surgery. Pringle maneuver for exclusion feeding vessels of the liver and the decrease of central venous pressure during anesthesia enabled further decrease of blood loss. Nowadays, 3D-CT imaging may depict feeding and drainage vessels in relation to liver mass, and surgeons can simulate hepatic surgery in virtual reality before surgery, allowing hepatectomy to be performed without blood transfusion. Thus, hepatic resection has been a safe procedure, but there's been a significant research on how much of the liver can be resected without hepatic failure. A prediction scoring system based on ICGR15, resection rates, and age is mostly reliable in some criteria. Even if hepatectomy is performed with a good prediction score, the massive bleeding and associated infection may induce postoperative hepatic failure, while the criteria of postoperative hepatic failure have not yet established. Hepatic failure is supposed to be induced by the apoptosis of mature hepatocytes and necrosis originated from microcirculation disturbance of the liver. Prostaglandin E1 for the improvement of microcirculation, steroid for the inhibition of cytokines inducing apoptosis, and blood purification to exclude cytokines have been tried separately or concomitantly. New therapeutic approaches, especially hepatic regeneration from the stem cell, are expected. (author)

  5. Resistance exercise-induced fluid shifts: change in active muscle size and plasma volume

    Science.gov (United States)

    Ploutz-Snyder, L. L.; Convertino, V. A.; Dudley, G. A.

    1995-01-01

    The purpose of this study was to test the hypothesis that the reduction in plasma volume (PV) induced by resistance exercise reflects fluid loss to the extravascular space and subsequently selective increase in cross-sectional area (CSA) of active but not inactive skeletal muscle. We compared changes in active and inactive muscle CSA and PV after barbell squat exercise. Magnetic resonance imaging (MRI) was used to quantify muscle involvement in exercise and to determine CSA of muscle groups or individual muscles [vasti (VS), adductor (Add), hamstring (Ham), and rectus femoris (RF)]. Muscle involvement in exercise was determined using exercise-induced contrast shift in spin-spin relaxation time (T2)-weighted MR images immediately postexercise. Alterations in muscle size were based on the mean CSA of individual slices. Hematocrit, hemoglobin, and Evans blue dye were used to estimate changes in PV. Muscle CSA and PV data were obtained preexercise and immediately postexercise and 15 and 45 min thereafter. A hierarchy of muscle involvement in exercise was found such that VS > Add > Ham > RF, with the Ham and RF showing essentially no involvement. CSA of the VS and Add muscle groups were increased 10 and 5%, respectively, immediately after exercise in each thigh with no changes in Ham and RF CSA. PV was decreased 22% immediately following exercise. The absolute loss of PV was correlated (r2 = 0.75) with absolute increase in muscle CSA immediately postexercise, supporting the notion that increased muscle size after resistance exercise reflects primarily fluid movement from the vascular space into active but not inactive muscle.

  6. Structural functional associations of the orbit in thyroid eye disease: Kalman filters to track extraocular rectal muscles

    Science.gov (United States)

    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L.; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-03-01

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention, and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, it is shown that the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease.

  7. Hip flexor muscle size, strength and recruitment pattern in patients with acetabular labral tears compared to healthy controls.

    Science.gov (United States)

    Mendis, M Dilani; Wilson, Stephen J; Hayes, David A; Watts, Mark C; Hides, Julie A

    2014-10-01

    Acetabular labral tears are a source of hip pain and are considered to be a precursor to hip osteoarthritis. Hip flexor muscles contribute to hip joint stability and function but it is unknown if their size and function is altered in the presence of labral pathology. This study aimed to investigate hip flexor muscle size, strength and recruitment pattern in patients with hip labral pathology compared to control subjects. 12 subjects diagnosed with an unilateral acetabular labral tear were compared to 12 control subjects matched for age and gender. All subjects underwent magnetic resonance imaging (MRI) of their lumbo-pelvic region. Average muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius, tensor fascia latae and rectus femoris muscles were measured. Hip flexion strength was measured by an externally fixed dynamometer. Individual muscle recruitment pattern during a resisted hip flexion exercise task was measured by muscle functional MRI. Hip flexor muscle strength was found to be decreased in patients with labral pathology compared to control subjects (p muscle size (all p > 0.17) and recruitment pattern (all p > 0.53). Decreased hip flexor muscle strength may affect physical function in patients with hip labral pathology by contributing to altered gait patterns and functional tasks. Clinical rehabilitation of these patients may need to include strengthening exercises for the hip flexor muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Knife-assisted snare resection: a novel technique for resection of scarred polyps in the colon.

    Science.gov (United States)

    Chedgy, Fergus J Q; Bhattacharyya, Rupam; Kandiah, Kesavan; Longcroft-Wheaton, Gaius; Bhandari, Pradeep

    2016-03-01

    There have been significant advances in the management of complex colorectal polyps. Previous failed resection or polyp recurrence is associated with significant fibrosis, making endoscopic resection extremely challenging; the traditional approach to these lesions is surgery. The aim of this study was to evaluate the efficacy of a novel, knife-assisted snare resection (KAR) technique in the resection of scarred colonic polyps. This was a prospective cohort study of patients, in whom the KAR technique was used to resect scarred colonic polyps > 2  cm in size. Patients had previously undergone endoscopic mucosal resection (EMR) and developed recurrence, or EMR had been attempted but was aborted as a result of technical difficulty. A total of 42 patients underwent KAR of large (median 40  mm) scarred polyps. Surgery for benign disease was avoided in 38 of 41 patients (93 %). No life-threatening complications occurred. Recurrence was seen in six patients (16 %), five of whom underwent further endoscopic resection. The overall cure rate for KAR in complex scarred colonic polyps was 90 %. KAR of scarred colonic polyps by an expert endoscopist was an effective and safe technique with low recurrence rates. © Georg Thieme Verlag KG Stuttgart · New York.

  9. [Laparoscopic resection of stomach in case of stomach ulcer].

    Science.gov (United States)

    Sazhin, I V; Sazhin, V P; Nuzhdikhin, A V

    2014-01-01

    Laparoscopic resection of stomach was done in 84 patients with complicated peptic ulcer of stomach and duodenum. There were 1.2% post-operative complications in case of laparoscopic resection of stomach in comparison with open resection, which had 33.3% complications. There were not deaths in case of laparoscopic resection of stomach. This indication was about 4% in patients after open resection. It was determined that functionalefficiency afterlaparoscopic resection was in 1.6-1.8 times higher than afteropen resectionof stomach.

  10. Muscle trigger point therapy in tension-type headache.

    Science.gov (United States)

    Alonso-Blanco, Cristina; de-la-Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César

    2012-03-01

    Recent evidence suggests that active trigger points (TrPs) in neck and shoulder muscles contribute to tension-type headache. Active TrPs within the suboccipital, upper trapezius, sternocleidomastoid, temporalis, superior oblique and lateral rectus muscles have been associated with chronic and episodic tension-type headache forms. It seems that the pain profile of this headache may be provoked by referred pain from active TrPs in the posterior cervical, head and shoulder muscles. In fact, the presence of active TrPs has been related to a higher degree of sensitization in tension-type headache. Different therapeutic approaches are proposed for proper TrP management. Preliminary evidence indicates that inactivation of TrPs may be effective for the management of tension-type headache, particularly in a subgroup of patients who may respond positively to this approach. Different treatment approaches targeted to TrP inactivation are discussed in the current paper, focusing on tension-type headache. New studies are needed to further delineate the relationship between muscle TrP inactivation and tension-type headache.

  11. [A case of polymyositis associated with transverse colon cancer that responded to tumor resection and chemotherapy].

    Science.gov (United States)

    Uchida, Yuichiro; Okabe, Michio; Kawamoto, Yusuke; Tsukumo, Yuta; Ito, Tadashi

    2015-04-01

    A 72-year-old woman was admitted to our hospital because of muscle weakness and was diagnosed as having polymyositis. Whole-body evaluation revealed advanced transverse colon cancer, and we therefore considered it likely that the patient had paraneoplastic myositis. We performed a curative surgical resection for colon cancer, after which her serum creatine phosphokinase(CPK)level greatly decreased. Steroid therapy was administered postoperatively. However, her CPK levels remained persistently high, even after steroid pulse therapy, and we considered that this was due to steroid-resistance myositis. We administered chemotherapy for colon cancer using 5-fluorouracil plus Leucovorin(5-FU/LV), after which the CPK levels gradually decreased. There have been few previous reports of polymyositis associated with colon cancer and a standard treatment for paraneoplastic myositis has not been established. Most clinicians believe that treatment of the primary tumor may contribute to an improvement of myositis, and in our case, tumor resection and chemotherapy were effective.

  12. Predictive images of postoperative levator resection outcome using image processing software.

    Science.gov (United States)

    Mawatari, Yuki; Fukushima, Mikiko

    2016-01-01

    This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection. Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller's muscle complex (levator resection). Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop ® ). Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery. Approximately 1 month postoperatively, we surveyed our patients using questionnaires. Fifty-six patients (89.2%) were satisfied with their postoperative appearances, and 55 patients (84.8%) positively responded to the usefulness of processed images to predict postoperative appearance. Showing processed images that predict postoperative appearance to patients prior to blepharoptosis surgery can be useful for those patients concerned with their postoperative appearance. This approach may serve as a useful tool to simulate blepharoptosis surgery.

  13. Different Muscle-Recruitment Strategies Among Elite Breaststrokers.

    Science.gov (United States)

    Guignard, Brice; Olstad, Bjørn H; Simbaña Escobar, David; Lauer, Jessy; Kjendlie, Per-Ludvik; Rouard, Annie H

    2015-11-01

    To investigate electromyographical (EMG) profiles characterizing the lower-limb flexion-extension in an aquatic environment in high-level breaststrokers. The 2-dimensional breaststroke kick of 1 international- and 2 national-level female swimmers was analyzed during 2 maximal 25-m swims. The activities of biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior were recorded. The breaststroke kick was divided in 3 phases, according to the movements performed in the sagittal plane: push phase (PP) covering 27% of the total kick duration, glide phase (GP) 41%, and recovery phase (RP) 32%. Intrasubject reproducibility of the EMG and kinematics was observed from 1 stroke cycle to another. In addition, important intersubject kinematic reproducibility was noted, whereas muscle activities discriminated the subjects: The explosive PP was characterized by important muscle-activation peaks. During the recovery, muscles were likewise solicited for swimmers 1 (S1) and 2 (S2), while the lowest activities were observed during GP for S2 and swimmer 3 (S3), but not for S1, who maintained major muscle solicitations. The main muscle activities were observed during PP to perform powerful lower-limb extension. The most-skilled swimmer (S1) was the only 1 to solicit her muscles during GP to actively reach better streamlining. Important activation peaks during RP correspond to the limbs acting against water drag. Such differences in EMG strategies among an elite group highlight the importance of considering the muscle parameters used to effectively control the intensity of activation among the phases for a more efficient breaststroke kick.

  14. Hysteroscopic Endometrial Resection in the Management of ...

    African Journals Online (AJOL)

    All women underwent hysteroscopic endometrial resection and 28 of them had hysteroscopic myomectomy. The success rate was 92.8% (65/70) after 2 years follow up. All the five women with failure of the procedure were younger ( 7 ...

  15. Expanded Endoscopic Endonasal Resection of Retrochiasmatic Craniopharyngioma.

    Science.gov (United States)

    Davanzo, Justin R; Goyal, Neerav; Zacharia, Brad E

    2018-02-01

    This video abstract demonstrates the use of the expanded endoscopic endonasal approach for the resection of a retrochiasmatic craniopharyngioma. These tumors are notoriously difficult to treat, and many approaches have been tried to facilitate safe and effective resection. The endoscopic endonasal approach has been increasingly utilized for selected sellar/suprasellar pathology. We present the case of a 39-year-old man who was found to have a cystic, partially calcified suprasellar mass consistent with a craniopharyngioma. To facilitate robust skull base repair, a vascularized nasoseptal flap was harvested. A wide sphenoidotomy was performed and the sella and tuberculum were exposed. After the dural opening and arachnoid dissection, the stalk was identified, merging seamlessly with the tumor capsule. The lesion was then internally debulked with the use of an ultrasonic aspirator. The capsule was then dissected off of the optic chiasm, thalamus, and hypothalamus. The cavity was inspected with an angled endoscope to ensure complete resection. A multilayered reconstruction was performed using autologous fascia lata, the previously harvested nasoseptal flap, and dural sealant. Postoperatively, the patient did have expected panhypopituitarism but remained neurologically intact and had improvement in his vision. In conclusion, this video demonstrates how an expanded endonasal approach can be used to safely resect a craniopharyngioma, even when in close proximity to delicate structures such as the optic chiasm. The link to the video can be found at: https://youtu.be/tahjHmrXhc4 .

  16. Resection methodology for PSP data processing: Recent ...

    Indian Academy of Sciences (India)

    M. Senthilkumar (Newgen Imaging) 1461 1996 Oct 15 13:05:22

    Abstract. PSP data processing, which primarily involves image alignment and image analysis, is a crucial element in obtaining accurate PSP results. There are two broad approaches to image alignment: the algebraic transformation technique, often called image-warping technique, and resection methodology, which uses ...

  17. What Keeps Postpulmonary Resection Patients in Hospital?

    Directory of Open Access Journals (Sweden)

    T Bardell

    2003-01-01

    Full Text Available BACKGROUND: Prolonged air leak (longer than three days was hypothesized to be the primary cause of extended hospital stays following pulmonary resection. Its effect on length of stay (LOS was compared with that of suboptimal pain control, nausea and vomiting, and other causes. Predictors of prolonged LOS and of prolonged air leaks were investigated.

  18. BLADDER NECK RESECTION WITH PRESERVATION OF ...

    African Journals Online (AJOL)

    Conclusion The complication of retrograde ejaculation in young patients who are in need of fertililty may be avoided by preservation of > 1 cm of the supramontanal part during bladder neck resection. La Résection du Col de Vessie avec Préservation de l'Ejaculation Antégrade Objectif Evaluer une nouvelle méthode de ...

  19. A rare indication for liver resection.

    Science.gov (United States)

    Popescu, I; Zamfir, R; Braşoveanu, V; Boroş, M; Herlea, V

    2005-01-01

    We present the rare case of a young female with a right upper abdomen tumoral mass and suffering abdominal discomfort. A combination of ultrasonography, computed tomography, magnetic resonance imaging and laparotomy was utilized to conclude a diagnosis of Riedel's lobe. Laparotomy and a resection of Riedel's lobe were selected as the correct therapeutic solutions.

  20. Single incision laparoscopic colorectal resection: Our experience

    Directory of Open Access Journals (Sweden)

    Chinnusamy Palanivelu

    2012-01-01

    Full Text Available Background: A prospective case series of single incision multiport laparoscopic colorectal resections for malignancy using conventional laparoscopic trocars and instruments is described. Materials and Methods: Eleven patients (seven men and four women with colonic or rectal pathology underwent single incision multiport laparoscopic colectomy/rectal resection from July till December 2010. Four trocars were placed in a single transumblical incision. The bowel was mobilized laparoscopically and vessels controlled intracorporeally with either intra or extracorporeal anastomosis. Results: Three patients had carcinoma in the caecum, one in the hepatic flexure, two in the rectosigmoid, one in the descending colon, two in the rectum and two had ulcerative pancolitis (one with high grade dysplasia and another with carcinoma rectum. There was no conversion to standard multiport laparoscopy or open surgery. The median age was 52 years (range 24-78 years. The average operating time was 130 min (range 90-210 min. The average incision length was 3.2 cm (2.5-4.0 cm. There were no postoperative complications. The average length of stay was 4.5 days (range 3-8 days. Histopathology showed adequate proximal and distal resection margins with an average lymph node yield of 25 nodes (range 16-30 nodes. Conclusion: Single incision multiport laparoscopic colorectal surgery for malignancy is feasible without extra cost or specialized ports/instrumentation. It does not compromise the oncological radicality of resection. Short-term results are encouraging. Long-term results are awaited.

  1. Outcome of colorectal cancer resection in octogenarians

    African Journals Online (AJOL)

    Colorectal cancer is predominantly a disease of the elderly. It is the second most common cancer in the UK and the third most common cause of cancer-related death.[1] Surgical resection, either for cure or palliation, remains the mainstay of treatment.[1,2]. Long-term survival is related to the extent of disease at diagnosis.

  2. Anaesthetic management of endoscopic resection of juvenile ...

    African Journals Online (AJOL)

    P Khanna, BR Ray, R Sinha, R Kumar, K Sikka, AC Singh ... We present the anaesthetic management of endoscopic resection of 14 JNAs, together with a review. ... Mean duration of surgery was 197.14 ± 77 minutes, and median blood loss ...

  3. Resection planning for robotic acoustic neuroma surgery

    Science.gov (United States)

    McBrayer, Kepra L.; Wanna, George B.; Dawant, Benoit M.; Balachandran, Ramya; Labadie, Robert F.; Noble, Jack H.

    2016-03-01

    Acoustic neuroma surgery is a procedure in which a benign mass is removed from the Internal Auditory Canal (IAC). Currently this surgical procedure requires manual drilling of the temporal bone followed by exposure and removal of the acoustic neuroma. This procedure is physically and mentally taxing to the surgeon. Our group is working to develop an Acoustic Neuroma Surgery Robot (ANSR) to perform the initial drilling procedure. Planning the ANSR's drilling region using pre-operative CT requires expertise and around 35 minutes' time. We propose an approach for automatically producing a resection plan for the ANSR that would avoid damage to sensitive ear structures and require minimal editing by the surgeon. We first compute an atlas-based segmentation of the mastoid section of the temporal bone, refine it based on the position of anatomical landmarks, and apply a safety margin to the result to produce the automatic resection plan. In experiments with CTs from 9 subjects, our automated process resulted in a resection plan that was verified to be safe in every case. Approximately 2 minutes were required in each case for the surgeon to verify and edit the plan to permit functional access to the IAC. We measured a mean Dice coefficient of 0.99 and surface error of 0.08 mm between the final and automatically proposed plans. These preliminary results indicate that our approach is a viable method for resection planning for the ANSR and drastically reduces the surgeon's planning effort.

  4. Magnetic resonance imaging analysis of the upper cervical spine extensor musculature in an asymptomatic cohort: an index of fat within muscle

    International Nuclear Information System (INIS)

    Elliott, J.M.; Galloway, G.J.; Jull, G.A.; Noteboom, J.T.; Centeno, C.J.; Gibbon, W.W.

    2005-01-01

    AIM: To establish a simple method to quantify muscle/fat constituents in cervical muscles of asymptomatic women using magnetic resonance imaging (MRI), and to determine whether there is an age effect within a defined age range. MATERIALS AND METHODS: MRI of the upper cervical spine was performed for 42 asymptomatic women aged 18-45 years. The muscle and fat signal intensities on axial spin echo T1-weighted images were quantitatively classified by taking a ratio of the pixel intensity profiles of muscle against those of intermuscular fat for the rectus capitis posterior major and minor and inferior obliquus capitis muscles bilaterally. Inter- and intra-examiner agreement was scrutinized. RESULTS: The average relative values of fat within the upper cervical musculature compared with intermuscular fat indicated that there were only slight variations in indices between the three sets of muscles. There was no significant correlation between age and fat indices. There were significant differences for the relative fat within the muscle compared with intermuscular fat and body mass index for the right rectus capitis posterior major and right and left inferior obliquus capitis muscles (p=0.032). Intraclass correlation coefficients for intraobserver agreement ranged from 0.94 to 0.98. Inter-rater agreement of the measurements ranged from 0.75 to 0.97. CONCLUSION: A quantitative measure of muscle/fat constituents has been developed, and results of this study indicate that relative fatty infiltration is not a feature of age in the upper cervical extensor muscles of women aged 18-45 years

  5. Magnetic resonance imaging analysis of the upper cervical spine extensor musculature in an asymptomatic cohort: an index of fat within muscle

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, J.M. [Division of Physiotherapy, University of Queensland, Brisbane, QLD (Australia)]. E-mail: jimelliott@plbb.net; Galloway, G.J. [Center for Magnetic Resonance, University of Queensland, Brisbane, QLD (Australia); Jull, G.A. [Division of Physiotherapy, University of Queensland, Brisbane, QLD (Australia); Noteboom, J.T. [Department of Physical Therapy, Regis University, Denver, CO, USA (United States); Centeno, C.J. [Centeno Clinic, Westminster, CO, USA (United States); Gibbon, W.W. [Department of Radiology, School of Medicine, University of Queensland, Brisbane, QLD (Australia)

    2005-03-01

    AIM: To establish a simple method to quantify muscle/fat constituents in cervical muscles of asymptomatic women using magnetic resonance imaging (MRI), and to determine whether there is an age effect within a defined age range. MATERIALS AND METHODS: MRI of the upper cervical spine was performed for 42 asymptomatic women aged 18-45 years. The muscle and fat signal intensities on axial spin echo T1-weighted images were quantitatively classified by taking a ratio of the pixel intensity profiles of muscle against those of intermuscular fat for the rectus capitis posterior major and minor and inferior obliquus capitis muscles bilaterally. Inter- and intra-examiner agreement was scrutinized. RESULTS: The average relative values of fat within the upper cervical musculature compared with intermuscular fat indicated that there were only slight variations in indices between the three sets of muscles. There was no significant correlation between age and fat indices. There were significant differences for the relative fat within the muscle compared with intermuscular fat and body mass index for the right rectus capitis posterior major and right and left inferior obliquus capitis muscles (p=0.032). Intraclass correlation coefficients for intraobserver agreement ranged from 0.94 to 0.98. Inter-rater agreement of the measurements ranged from 0.75 to 0.97. CONCLUSION: A quantitative measure of muscle/fat constituents has been developed, and results of this study indicate that relative fatty infiltration is not a feature of age in the upper cervical extensor muscles of women aged 18-45 years.

  6. Changes in contractile properties of muscles receiving repeat injections of botulinum toxin (Botox).

    Science.gov (United States)

    Fortuna, Rafael; Vaz, Marco Aurélio; Youssef, Aliaa Rehan; Longino, David; Herzog, Walter

    2011-01-04

    Botulinum toxin type A (BTX-A) is a frequently used therapeutic tool to denervate muscles in the treatment of neuromuscular disorders. Although considered safe by the US Food and Drug Administration, BTX-A can produce adverse effects in target and non-target muscles. With an increased use of BTX-A for neuromuscular disorders, the effects of repeat injections of BTX-A on strength, muscle mass and structure need to be known. Therefore, the purpose of this study was to investigate the changes in strength, muscle mass and contractile material in New Zealand White (NZW) rabbits. Twenty NZW rabbits were divided into 4 groups: control and 1, 3 and 6 months of unilateral, repeat injections of BTX-A into the quadriceps femoris. Outcome measures included knee extensor torque, muscle mass and the percentage of contractile material in the quadriceps muscles of the target and non-injected contralateral hindlimbs. Strength in the injected muscles was reduced by 88%, 89% and 95% in the 1, 3 and 6 months BTX-A injected hindlimbs compared to controls. Muscle mass was reduced by 50%, 42% and 31% for the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM), respectively, at 1 month, by 68%, 51% and 50% at 3 months and by 76%, 44% and 13% at 6 months. The percentage of contractile material was reduced for the 3 and 6 months animals to 80-64%, respectively, and was replaced primarily by fat. Similar, but less pronounced results were also observed for the quadriceps muscles of the contralateral hindlimbs, suggesting that repeat BTX-A injections cause muscle atrophy and loss of contractile tissue in target muscles and also in non-target muscles that are far removed from the injection site. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. Prematurity reduces functional adaptation to intestinal resection in piglets

    DEFF Research Database (Denmark)

    Aunsholt, Lise; Thymann, Thomas; Qvist, Niels

    2015-01-01

    Background: Necrotizing enterocolitis and congenital gastrointestinal malformations in infants often require intestinal resection, with a subsequent risk of short bowel syndrome (SBS). We hypothesized that immediate intestinal adaptation following resection of the distal intestine with placement ...

  8. Learning Transurethral Resection of the Prostate: A Comparison of ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... benign prostate enlargement (BPE) are of limited use in the resource‑poor ... trans‑urethral resection of the prostate, resected weight, retropubic prostatectomy ..... digital rectal examination and total prostate specific antigen.

  9. [Laparoscopic resection of the sigmoid colon for the diverticular disease].

    Science.gov (United States)

    Vrbenský, L; Simša, J

    2013-07-01

    Laparoscopic resection of the sigmoid colon for diverticular disease is nowadays a fully accepted alternative to traditional open procedures. The aim of this work is to summarize the indications, advantages and risks of laparoscopic sigmoid resection for diverticular disease. Review of the literature and recent findings concerning the significance of laparoscopic resection for diverticulosis of the sigmoid colon. The article presents the indications, risks, techniques and perioperative care in patients after laparoscopic resection of the sigmoid colon for diverticular disease.

  10. Nondestructive Estimation of Muscle Contributions to STS Training with Different Loadings Based on Wearable Sensor System.

    Science.gov (United States)

    Liu, Kun; Liu, Yong; Yan, Jianchao; Sun, Zhenyuan

    2018-03-25

    Partial body weight support or loading sit-to-stand (STS) rehabilitation can be useful for persons with lower limb dysfunction to achieve movement again based on the internal residual muscle force and external assistance. To explicate how the muscles contribute to the kinetics and kinematics of STS performance by non-invasive in vitro detection and to nondestructively estimate the muscle contributions to STS training with different loadings, a wearable sensor system was developed with ground reaction force (GRF) platforms, motion capture inertial sensors and electromyography (EMG) sensors. To estimate the internal moments of hip, knee and ankle joints and quantify the contributions of individual muscle and gravity to STS movement, the inverse dynamics analysis on a simplified STS biomechanical model with external loading is proposed. The functional roles of the lower limb individual muscles (rectus femoris (RF), gluteus maximus (GM), vastus lateralis (VL), tibialis anterior (TA) and gastrocnemius (GAST)) during STS motion and the mechanism of the muscles' synergies to perform STS-specific subtasks were analyzed. The muscle contributions to the biomechanical STS subtasks of vertical propulsion, anteroposterior (AP) braking and propulsion for body balance in the sagittal plane were quantified by experimental studies with EMG, kinematic and kinetic data.

  11. Assessment of muscle fatigue after an ultra-endurance triathlon using tensiomyography (TMG).

    Science.gov (United States)

    García-Manso, Juan Manuel; Rodríguez-Ruiz, David; Rodríguez-Matoso, Dario; de Saa, Yves; Sarmiento, Samuel; Quiroga, Miriam

    2011-03-01

    In this study, we used tensiomyography (TMG) to assess muscle status immediately after an ultra-endurance triathlon. Maximal radial displacement or deformation of the muscle belly, contraction time, delay time, sustain time, and relaxation time were measured for both legs, and dependent t-tests were used to compare means between the beginning and end of the race. The 19 men assessed (age 37.9 ± 7.1 years; height 177.5 ± 4.6 cm; weight: 73.6 ± 6.5 kg) participated in the 2009 edition of the Lanzarote Ironman. Deterioration in the neural response was observed for contraction time (P = 0.008) and relaxation time (P = 0.011), with a moderate decrease in the response time (sustain time) and a loss in muscle stiffness (deformation of the muscle belly). The effect of muscle fatigue on the rectus femoris and biceps femoris was different. Barely any changes in contraction time, relaxation time, sustain time, and deformation of the muscle belly were observed, while only the contraction response time decreased to a significant extent (reduction in delay time; P = 0.003). The considerable loss in contractile capacity induced by a long-distance race was reflected in changes in the neuromuscular response and fluctuations in the contractile capacity of the muscle. These modifications, derived from a prolonged, exhausting effort, can be assessed in a simple, non-aggressive, non-invasive way using tensiomyography.

  12. Changes in shoulder muscle activity pattern on surface electromyography after breast cancer surgery.

    Science.gov (United States)

    Yang, Eun Joo; Kwon, YoungOk

    2018-02-01

    Alterations in muscle activation and restricted shoulder mobility, which are common in breast cancer patients, have been found to affect upper limb function. The purpose of this study was to determine muscle activity patterns, and to compare the prevalence of abnormal patterns among the type of breast surgery. In total, 274 breast cancer patients were recruited after surgery. Type of breast surgery was divided into mastectomy without reconstruction (Mastectomy), reconstruction with tissue expander/implant (TEI), latissimus dorsi (LD) flap, or transverse rectus abdominis flap (TRAM). Activities of shoulder muscles were measured using surface electromyography. Experimental analysis was conducted using a Gaussian filter smoothing method with regression. Patients demonstrated different patterns of muscle activation, such as normal, lower muscle electrical activity, and tightness. After adjusting for BMI and breast surgery, the odds of lower muscle electrical activity and tightness in the TRAM are 40.2% and 38.4% less than in the Mastectomy only group. The prevalence of abnormal patterns was significantly greater in the ALND than SLNB in all except TRAM. Alterations in muscle activity patterns differed by breast surgery and reconstruction type. For breast cancer patients with ALND, TRAM may be the best choice for maintaining upper limb function. © 2017 Wiley Periodicals, Inc.

  13. Effects of photobiomodulation therapy (pulsed LASER 904 nm) on muscle oxygenation and performance in exercise-induced skeletal muscle fatigue in young women: a pilot study

    Science.gov (United States)

    Oliveira, Murilo X.; Toma, Renata L.; Jones, Brett J. L.; Cyprien, Thomas P.; Tier, Matthew R.; Wallace, Cameron A.; Renno, Ana C. M.; Sabapathy, Surendran; Laakso, E.-Liisa

    2017-02-01

    Photobiomodulation therapy (PBMt) has been used to increase muscle performance and improve recovery when applied before exercise. We aimed to evaluate the effects of PBMt using LASER on muscle oxygenation and performance. The study was a randomized, participant and assessor-blinded, within-subject crossover trial with placebo control to test the viability of the methods. Five physically active young women were randomly assigned to either placebo, or active PBMt (12 diode cluster probe; 904 nm; 60 mW; 250 Hz; 43.2 J per site, 129.6 J total) in contact over rectus femoris (RF) muscle of the dominant limb immediately before an isokinetic fatigue protocol. A one-week wash-out period preceded cross-over. Electromyography and isokinetic performance measures were evaluated. Absolute concentrations of deoxygenated haemoglobin and myoglobin (deoxy[Hb + Mb]) of the RF, an index of local microvascular fractional O2 extraction, was monitored continuously by near-infrared spectroscopy (NIRS). Total haemoglobin concentration as an indicator of microvascular haematocrit was calculated as the sum of the deoxy[Hb + Mb] and oxy[Hb + Mb] signals. PBMt pre-conditioning reduced time to peak torque when compared to placebo (P0.05). PBMt before exercise improves indicators of muscle performance, potentially by increasing local matching of bulk and microvascular O2 delivery relative to skeletal muscle O2 utilisation. Further work is required to understand the effect of PBMt on haemodynamic and metabolic characteristics of muscle.

  14. Prognostic Factors Predicting the Surgical Outcomes of Bilateral Lateral Rectus Recession for Patients with Concomitant Exotropia in Chiang Mai University Hospital.

    Science.gov (United States)

    Trakanwitthayarak, Supaporn; Patikulsila, Prapatsorn

    2017-01-01

    To determine the preoperative variables affecting early and late favorable outcomes of bilateral lateral rectus recession surgery for concomitant exotropia. A retrospective study of 65 patients with concomitant exotropia (constant and intermittent) who had bilateral lateral rectus recession was conducted. The follow-up period was more than 1 year in all patients. Preoperative parameters were obtained and evaluated using univariate analysis. Sixty-five patients with concomitant exotropia who underwent bilateral lateral rectus recession were included. In the early and late postoperative outcome, 78% and 82% of the patients were in the success group, respectively. Meanwhile, 22% and 18% were in the failure group, respectively. There was no association between postoperative outcome and preoperative variables i.e. age at onset (p = 0.841, 0.591), age at surgery (p = 0.564, 0.634), interval between onset and surgery (p = 0.506, 0.753), preoperative deviation (p = 0.278, 0.211), refractive error (p = 0.217, 0.136), anisometropia (p = 0.946, 0.946), phase of exotropia (p = 0.741, 0.013), A-V pattern (p = 1.000, 1.000), stereopsis (p = 0.841, 0.268) and amblyopia (p = 0.569, 0.567). Preoperative variables could not be used to predict the early and late postoperative outcome.

  15. Effect of rectus recession combined with the rear suspension scleral fixation in patients with restrictive strabismus caused by thyroid associated ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Hai-Hua Qian

    2016-04-01

    Full Text Available AIM: To investigate the therapeutic effect of rectus recession combined with the rear suspension scleral fixation for patients with restrictive strabismus caused by thyroid associated ophthalmopathy(TAO. METHODS: The clinical data of 48 patients(71 eyeswith severe TAO were retrospective analyzed from January 2013 to January 2015.The patients with severe TAO were divided into the exophthalmos(EMgroup with 25 patients(35 eyes, compressive optic neuropathy(CONgroup with 12 patients(20 eyesand exposure keratopathy(EKgroup with 11 patients(16 eyes.The rectus recession combined with rear suspension scleral fixation treatment was performed in all patients. The visual acuity, clinical activity score(CAS, and diplopia situation of each group were recorded and compared preoperatively and at 6mo postoperatively. RESULTS: The postoperative best corrected visual acuity(BCVAof the three groups were significantly higher than those before operation(PPPPPCONCLUSION: Rectus recession combined with the rear suspension scleral fixation can help improve the restrictive strabismus caused by TAO, visual acuity, eyeballs to roll back, eliminate the diplopia and to improve the life quality of patients.

  16. Can immediate second resection be an alternative to standardized second transurethral resection of bladder tumors?

    Directory of Open Access Journals (Sweden)

    Engin Doğantekin

    2016-03-01

    Full Text Available This study analyzed the impact of an immediate second transurethral resection of bladder tumor (TURBT protocol on residual tumor status at the initial TURBT session and the recurrence rate in the primary resection area. We prospectively evaluated and randomized 47 consecutive patients who underwent TURBT sessions for bladder cancer. In accordance with the inclusion criteria, of the 47 consecutive patients, 19 (Group I underwent immediate second resection of the tumor bed after complete TUR and 28 (Group II did not. After standard TURBT, Group I underwent a second cystoscopy and resection of the bed of the tumor or an ignored tumor, which was performed by a different urologist. After 4–6 weeks, delayed second TURB was performed, and all pathological results were evaluated. Tumors were detected in two patients during the immediate second resection. Of these, one was a misdiagnosed tumor, whereas the other was diagnosed at the bed of the tumor by pathological examination. Tumors were detected in nine patients at the delayed second TURB, of which only one was part of Group I, while the others were part of Group II (p = 0.04. The results of this study demonstrated that residual tumors may remain after initial TURB, either in the tumor bed or in a different location within the bladder. Although this was a pilot study enrolling only a small number of patients, our initial results supported the assertion that immediate second resection can be an alternative to standard second TURBT.

  17. Passive mechanical properties of rat abdominal wall muscles suggest an important role of the extracellular connective tissue matrix.

    Science.gov (United States)

    Brown, Stephen H M; Carr, John Austin; Ward, Samuel R; Lieber, Richard L

    2012-08-01

    Abdominal wall muscles have a unique morphology suggesting a complex role in generating and transferring force to the spinal column. Studying passive mechanical properties of these muscles may provide insights into their ability to transfer force among structures. Biopsies from rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were harvested from male Sprague-Dawley rats, and single muscle fibers and fiber bundles (4-8 fibers ensheathed in their connective tissue matrix) were isolated and mechanically stretched in a passive state. Slack sarcomere lengths were measured and elastic moduli were calculated from stress-strain data. Titin molecular mass was also measured from single muscle fibers. No significant differences were found among the four abdominal wall muscles in terms of slack sarcomere length or elastic modulus. Interestingly, across all four muscles, slack sarcomere lengths were quite long in individual muscle fibers (>2.4 µm), and demonstrated a significantly longer slack length in comparison to fiber bundles (p resistance to lengthening at long muscle lengths. Titin molecular mass was significantly less in TrA compared to each of the other three muscles (p < 0.0009), but this difference did not correspond to hypothesized differences in stiffness. Copyright © 2012 Orthopaedic Research Society.

  18. Augmented reality in bone tumour resection: An experimental study.

    Science.gov (United States)

    Cho, H S; Park, Y K; Gupta, S; Yoon, C; Han, I; Kim, H-S; Choi, H; Hong, J

    2017-03-01

    We evaluated the accuracy of augmented reality (AR)-based navigation assistance through simulation of bone tumours in a pig femur model. We developed an AR-based navigation system for bone tumour resection, which could be used on a tablet PC. To simulate a bone tumour in the pig femur, a cortical window was made in the diaphysis and bone cement was inserted. A total of 133 pig femurs were used and tumour resection was simulated with AR-assisted resection (164 resection in 82 femurs, half by an orthropaedic oncology expert and half by an orthopaedic resident) and resection with the conventional method (82 resection in 41 femurs). In the conventional group, resection was performed after measuring the distance from the edge of the condyle to the expected resection margin with a ruler as per routine clinical practice. The mean error of 164 resections in 82 femurs in the AR group was 1.71 mm (0 to 6). The mean error of 82 resections in 41 femurs in the conventional resection group was 2.64 mm (0 to 11) (p Augmented reality in bone tumour resection: An experimental study. Bone Joint Res 2017;6:137-143. © 2017 Cho et al.

  19. Short-term outcomes following laparoscopic resection for colon cancer.

    LENUS (Irish Health Repository)

    Kavanagh, Dara O

    2011-03-01

    Laparoscopic resection for colon cancer has been proven to have a similar oncological efficacy compared to open resection. Despite this, it is performed by a minority of colorectal surgeons. The aim of our study was to evaluate the short-term clinical, oncological and survival outcomes in all patients undergoing laparoscopic resection for colon cancer.

  20. Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series

    Directory of Open Access Journals (Sweden)

    Delanois Ronald E

    2009-08-01

    Full Text Available Abstract Background Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. Methods Ten patients (14 hips who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. Results At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees. Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points prior to injection to a mean of 96 points (range, 93 to 98 at final follow-up. There were no serious treatment-related adverse events. Conclusion Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy.

  1. Histological evaluation of levator palpebralis superior muscle in patients with congenital blepharoptosis

    Directory of Open Access Journals (Sweden)

    Sevda Söker

    2011-03-01

    Full Text Available The aim of this study was to examine levator palpebralis superior muscle histologically in patients with congenital blepharoptosis and to investigate the relationship between these findings and age, sex and degree of blefaroptosis in this patient group.Materials and methods: Levator muscle of 13 patients with congenital ptosis, who had applied to Dicle University Medical Faculty Ophthalmology Clinic and had undergone levator palpebralis superior muscle resection between january 2009-january 2010, has been examined histopathologically in Histology and Embriology Deparment. During preoperative period, ptosis amount, levator function (LF, tear functions, Bell’s phenomenon and jaw-winking phenomenon were evaluated. All patients underwent resection of levator palpebralis superior muscle. Received postoperative levator muscle was examined by light microscopy.Results: The average age of 9 (69.2% male and 4 (30.8% female cases were 10.61 ± 4.77 (4- 19 years. In histological examination, the quality and quantity of the levator muscle fibrils have been assessed. There was no relationship detected between histological features of levator palpebralis superior muscle and patient’s age and gender (p>0.05. Patients with weak levator palpebralis superior muscle were detected to have fatty degeneration histologically. The higher the levator palpebralis superior muscle function revealed decreased fatty degeneration and increased skeletal muscle fibrils.Conclusion: More ultrastructural studies in larger populations are needed to support the relationship between structure and function of levator palpebralis superior muscle in patients with congenital blepharoptosis.

  2. Coverage of Megaprosthesis with Human Acellular Dermal Matrix after Ewing's Sarcoma Resection: A Case Report

    Directory of Open Access Journals (Sweden)

    Robert M. Whitfield

    2011-01-01

    Full Text Available A 23-year-old female with Ewing's Sarcoma underwent tibial resection and skeletal reconstruction using proximal tibial allograft prosthetic reconstruction with distal femur endoprosthetic reconstruction and rotating hinge. Human acellular dermal matrix, (Alloderm, LifeCell, Branchburg, NJ, USA, was used to wrap the skeletal reconstruction. Soft tissue reconstruction was completed with a rotational gastrocnemius muscle flap and skin graft. Despite prolonged immobilization, the patient quickly regained full range of motion of her skeletal reconstruction. Synthetic mesh, tapes and tubes are used to perform capsule reconstruction of megaprosthesis. This paper describes the role of human acellular dermal matrix in capsule reconstruction around a megaprosthesis.

  3. Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study.

    Science.gov (United States)

    Ptaszkowski, Kuba; Paprocka-Borowicz, Małgorzata; Słupska, Lucyna; Bartnicki, Janusz; Dymarek, Robert; Rosińczuk, Joanna; Heimrath, Jerzy; Dembowski, Janusz; Zdrojowy, Romuald

    2015-01-01

    Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman's ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the mechanism of continence.

  4. Clinical predictors of resectability of pancreatic adenocarcinoma.

    Science.gov (United States)

    Almadi, Majid A; Alharbi, Othman; Azzam, Nahla; Altayeb, Mohannad; Javed, Moammed; Alsaif, Faisal; Hassanain, Mazen; Alsharabi, Abdulsalam; Al-Saleh, Khalid; Aljebreen, Abdulrahman M

    2013-01-01

    Identifying patient-related factors as well as symptoms and signs that can predict pancreatic cancer at a resectable stage, which could be used in an attempt to identify patients at an early stage of pancreatic cancer that would be appropriate for surgical resection and those at an unresectable stage be sparred unnecessary surgery. A retrospective chart review was conducted at a major tertiary care, university hospital in Riyadh, Saudi Arabia. The study population included individuals who underwent a computed tomography and a pancreatic mass was reported as well as the endoscopic reporting database of endoscopic procedures where the indication was a pancreatic mass, between April 1996 and April 2012. Any patient with a histologically confirmed diagnosis of adenocarcinoma of the pancreas was included in the analysis. We included patients' demographic information (age, gender), height, weight, body mass index, historical data (smoking, comorbidities), symptoms (abdominal pain and its duration, anorexia and its duration, weight loss and its amount, and over what duration, vomiting, abdominal distention, itching and its duration, change in bowel movements, change in urine color), jaundice and its duration. Other variables were also collected including laboratory values, location of the mass, the investigation undertaken, and the stage of the tumor. A total of 61 patients were included, the mean age was 61.2 ± 1.51 years, 25 (41%) were females. The tumors were located in the head (83.6%), body (10.9%), tail (1.8%), and in multiple locations (3.6%) of the pancreas. Half of the patients (50%) had Stage IV, 16.7% stages IIB and III, and only 8.3% were stages IB and IIA. On univariable analysis a lower hemoglobin level predicted resectability odds ratio 0.65 (95% confidence interval, 0.42-0.98), whereas on multivariable regression none of the variables included in the model could predict resectability of pancreatic cancer. A CA 19-9 cutoff level of 166 ng/mL had a

  5. Muscle activation patterns during walking from transtibial amputees recorded within the residual limb-prosthetic interface

    Directory of Open Access Journals (Sweden)

    Huang Stephanie

    2012-08-01

    Full Text Available Abstract Background Powered lower limb prostheses could be more functional if they had access to feedforward control signals from the user’s nervous system. Myoelectric signals are one potential control source. The purpose of this study was to determine if muscle activation signals could be recorded from residual lower limb muscles within the prosthetic socket-limb interface during walking. Methods We recorded surface electromyography from three lower leg muscles (tibilias anterior, gastrocnemius medial head, gastrocnemius lateral head and four upper leg muscles (vastus lateralis, rectus femoris, biceps femoris, and gluteus medius of 12 unilateral transtibial amputee subjects and 12 non-amputee subjects during treadmill walking at 0.7, 1.0, 1.3, and 1.6 m/s. Muscle signals were recorded from the amputated leg of amputee subjects and the right leg of control subjects. For amputee subjects, lower leg muscle signals were recorded from within the limb-socket interface and from muscles above the knee. We quantified differences in the muscle activation profile between amputee and control groups during treadmill walking using cross-correlation analyses. We also assessed the step-to-step inter-subject variability of these profiles by calculating variance-to-signal ratios. Results We found that amputee subjects demonstrated reliable muscle recruitment signals from residual lower leg muscles recorded within the prosthetic socket during walking, which were locked to particular phases of the gait cycle. However, muscle activation profile variability was higher for amputee subjects than for control subjects. Conclusion Robotic lower limb prostheses could use myoelectric signals recorded from surface electrodes within the socket-limb interface to derive feedforward commands from the amputee’s nervous system.

  6. Diffusion-Tensor Imaging of Thigh Muscles in Duchenne Muscular Dystrophy: Correlation of Apparent Diffusion Coefficient and Fractional Anisotropy Values With Fatty Infiltration.

    Science.gov (United States)

    Li, Gui Dian; Liang, Ying Yin; Xu, Ping; Ling, Jian; Chen, Ying Ming

    2016-04-01

    The purpose of this study is to investigate the correlation of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values with fatty infiltration in the thigh muscles of patients with Duchenne muscular dystrophy (DMD) using diffusion-tensor imaging (DTI). Twenty-one boys with DMD were recruited. The grade of fatty infiltration and the ADC and FA values of four thigh muscles (rectus femoris, semitendinosus, sartorius, and gracilis) were measured, and the FA and ADC values were compared with the grade of fatty infiltration. Twenty age-matched healthy boys were enrolled as the control group. The differences in the ADC and FA values of the thigh muscles between patients with DMD and the control group were compared. The patients with DMD showed lower FA values and higher ADC values in all measured muscles when compared with the control group. The FA and ADC values were correlated with the grade of fatty infiltration. For the rectus femoris muscle, r = -0.753 and p = 0.007 for FA, and r = 0.685 and p = 0.001 for ADC. For the semitendinosus muscle, r = -0.621 and p = 0.041 for FA, and r = 0.705 and p = 0.021 for ADC. For the sartorius muscle, r = -0.662 and p = 0.027 for FA, and r = 0.701 and p = 0.017 for ADC. For the gracilis muscle, r = -0.618 and p = 0.043 for FA, and r = 0.695 and p = 0.022 for ADC. Damage to the thigh muscles in patients with DMD can be detected by ADC and FA values using DTI. DTI can be used to assess the severity of the disease.

  7. Changes in Quadriceps Muscle Activity During Sustained Recreational Alpine Skiing

    Science.gov (United States)

    Kröll, Josef; Müller, Erich; Seifert, John G.; Wakeling, James M.

    2011-01-01

    During a day of skiing thousands of repeated contractions take place. Previous research on prolonged recreational alpine skiing show that physiological changes occur and hence some level of fatigue is inevitable. In the present paper the effect of prolonged skiing on the recruitment and coordination of the muscle activity was investigated. Six subjects performed 24 standardized runs. Muscle activity during the first two (PREskiing) and the last two (POSTskiing) runs was measured from the vastus lateralis (VL) and rectus femoris (RF) using EMG and quantified using wavelet and principal component analysis. The frequency content of the EMG signal shifted in seven out of eight cases significantly towards lower frequencies with highest effects observed for RF on outside leg. A significant pronounced outside leg loading occurred during POSTskiing and the timing of muscle activity peaks occurred more towards turn completion. Specific EMG frequency changes were observed at certain time points throughout the time windows and not over the whole double turn. It is suggested that general muscular fatigue, where additional specific muscle fibers have to be recruited due to the reduced power output of other fibers did not occur. The EMG frequency decrease and intensity changes for RF and VL are caused by altered timing (coordination) within the turn towards a most likely more uncontrolled skiing technique. Hence, these data provide evidence to suggest recreational skiers alter their skiing technique before a potential change in muscle fiber recruitment occurs. Key points The frequency content of the EMG signal shifted in seven out of eight cases significantly towards lower frequencies with highest effects observed for RF. General muscular fatigue, where additional specific fibers have to be recruited due to the reduced power output of other fibers, did not occur. A modified skiing style towards a less functional and hence more uncontrolled skiing technique seems to be a key

  8. Transurethral resection of very large prostates. A retrospective study

    DEFF Research Database (Denmark)

    Waaddegaard, P; Hansen, B J; Christensen, S W

    1991-01-01

    Twenty-one patients with benign prostatic hypertrophy (BPH), and a weight of transurethrally resected tissue exceeding 80 g (Group 1), were compared to a control group of 30 patients with a weight of resected tissue less than 80 g (Group 2) with regard to the peri- and postoperative course...... resections performed had a longer operating time and a greater perioperative blood loss than the group of minor resections. No differences were found with regard to other peri- or postoperative complications or subjective results. Transurethral resection is safe and efficient in treating BPH, also with very...

  9. Clinicoroentgenological assessment of the state of the resected larynx

    Energy Technology Data Exchange (ETDEWEB)

    Demidov, V.P.; Bityutskij, P.G.; Sorokina, N.A.; Kozhanov, L.G. (Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Onkologii)

    A study was made of an X-ray picture of the larynx and the state of the pharyngoesophageal anastomosis after salvage operations in 72 patients. Horizontal resection was performed in 42 patients, frontal-lateral in 27 and reconstructive laryngectomy in 3. An analysis of clinicoroentgenological changes showed that their nature depended on the type of resection and the area of resected anatomical structures and elements in the larynx as well as on concomitant manifestations of tumor recurrence or inflammatory disorders. Accurate data on resection type and the area of resectable laryngeal structures are indispensable in assessing X-ray changes.

  10. Benchmarking circumferential resection margin (R1) resection rate for rectal cancer in the neoadjuvant era.

    Science.gov (United States)

    Chambers, W; Collins, G; Warren, B; Cunningham, C; Mortensen, N; Lindsey, I

    2010-09-01

    Circumferential resection margin (CRM) involvement (R1) is used to audit rectal cancer surgical quality. However, when downsizing chemoradiation (dCRT) is used, CRM audits both dCRT and surgery, its use reflecting a high casemix of locally advanced tumours. We aimed to evaluate predictors of R1 and benchmark R1 rates in the dCRT era, and to assess the influence of failure of steps in the multidisciplinary team (MDT) process to CRM involvement. A retrospective analysis of prospectively collected rectal cancer data was undertaken. Patients were classified according to CRM status. Uni- and multivariate analysis was undertaken of risk factors for R1 resection. The contribution of the steps of the MDT process to CRM involvement was assessed. Two hundred and ten rectal cancers were evaluated (68% T3 or T4 on preoperative staging). R1 (microscopic) and R2 (macroscopic) resections occurred in 20 (10%) and 6 patients (3%), respectively. Of several factors associated with R1 resections on univariate analysis, only total mesorectal excision (TME) specimen defects and threatened/involved CRM on preoperative imaging remained as independent predictors of R1 resections on multivariate analysis. Causes of R1 failure by MDT step classification found that less than half were associated with and only 15% solely attributable to a suboptimal TME specimen. Total mesorectal excision specimen defects and staging-predicted threatened or involved CRM are independent strong predictors of R1 resections. In most R1 resections, the TME specimen was intact. It is important to remember the contribution of both the local staging casemix and dCRT failure when using R1 rates to assess purely surgical competence.

  11. Impact of selective pituitary gland incision or resection on hormonal function after adenoma or cyst resection.

    Science.gov (United States)

    Barkhoudarian, Garni; Cutler, Aaron R; Yost, Sam; Lobo, Bjorn; Eisenberg, Amalia; Kelly, Daniel F

    2015-12-01

    With the resection of pituitary lesions, the anterior pituitary gland often obstructs transsphenoidal access to the lesion. In such cases, a gland incision and/or partial gland resection may be required to obtain adequate exposure. We investigate this technique and determine the associated risk of post-operative hypopituitarism. All patients who underwent surgical resection of a pituitary adenoma or Rathke cleft cyst (RCC) between July 2007 and January 2013 were analyzed for pre- and post-operative hormone function. The cohort of patients with gland incision/resection were compared to a case-matched control cohort of pituitary surgery patients. Total hypophysectomy patients were excluded from outcome analysis. Of 372 operations over this period, an anterior pituitary gland incision or partial gland resection was performed in 79 cases (21.2 %). These include 53 gland incisions, 12 partial hemi-hypophysectomies and 14 resections of thinned/attenuated anterior gland. Diagnoses included 64 adenomas and 15 RCCs. New permanent hypopituitarism occurred in three patients (3.8 %), including permanent DI (3) and growth hormone deficiency (1). There was no significant difference in the rate of worsening gland dysfunction nor gain of function. Compared to a control cohort, there was a significantly lower incidence of transient DI (1.25 vs. 11.1 %, p = 0.009) but no significant difference in permanent DI (3.8 vs. 4.0 %) in the gland incision group. Selective gland incisions and gland resections were performed in over 20 % of our cases. This technique appears to minimize traction on compressed normal pituitary gland during removal of large lesions and facilitates better visualization and removal of cysts, microadenomas and macroadenomas.

  12. Computed tomographic appearance of resectable pancreatic carcinoma

    International Nuclear Information System (INIS)

    Itai, Y.; Araki, T.; Tasaka, A.; Maruyama, M.

    1982-01-01

    Thirteen patients with resectable pancreatic carcinoma were examined by computed tomography (CT). Nine had a mass, 2 had dilatation of the main pancreatic duct, 1 appeared to have ductal dilatation, and 1 had no sign of abnormality. Resectable carcinoma was diagnosed retrospectively in 8 cases, based on the following criteria: a mass with a distinct contour, frequently containing a tiny or irregular low-density area and accompanied by dilatation of the caudal portion of the main pancreatic duct without involvement of the large vessels, liver, or lymph nodes. Including unresectable cancer, chronic pancreatitis, and obstructive jaundice from causes other than cancer, the false-positive rate was less than 6%. However, a small cancer without change in pancreatic contour is difficult to detect with CT

  13. Transurethral resection for botryoid bladder rhabdomyosarcoma

    Directory of Open Access Journals (Sweden)

    Mitsuyuki Nakata

    2018-01-01

    Full Text Available The outcome of multimodal therapy for localized bladder rhabdomyosarcoma is quite good in terms of morbidity, and conservative surgery is generally recommended. However, in cases originating in the bladder neck, tumorectomy or partial cystectomy has adverse effects on bladder function. A 2-year-old girl underwent transurethral resection of a bladder tumor (TUR-BT, chemotherapy consisting of vincristine, actinomycin-D, and cyclophosphamide, and radiotherapy. She was in remission for 3 years when frequent urination became evident. Her bladder capacity and compliance were low; however, her urinary symptom was controlled using anticholinergic medication. Accordingly, TUR-BT could be an optional approach for bladder rhabdomyosarcoma. Keywords: Rhabdomyosarcoma, Transurethral resection, Conservative surgery

  14. Neuronavigation for the resection of cavernous angiomas.

    Science.gov (United States)

    Du, G; Zhou, L

    1999-08-01

    To introduce the use of the StealthStation neuronavigator combined with preoperative computerized tomography (CT) in resection of intracranial cavernous angiomas (CAs). The StealthStation neuronavigator was used to provide a realtime correlation of the operating field and the computerized images in 6 patients with CAs. All patients suffered from epileptic seizures. Four patients underwent keyhole surgery and 2 underwent small skin-flap craniotomy. The mean follow-up was 4.5 months. With the guidance of neuronavigator, lesionectomy associated with removal of hemosiderin deposition, gliosis and calcification was performed precisely. The mean fiducial error was from 1.65 mm to 4.53 mm, the predicted accuracy at 10 cm was between 1.82 mm and 3.28 mm, and the sustained accuracy ranged from 0.50 mm to 3.45 mm. The StealthStation neuronavigator is reliable and accurate in the resection of CAs.

  15. Neuropraxia following resection of a retroperitoneal liposarcoma

    Directory of Open Access Journals (Sweden)

    Stevenson Tsiao

    2017-01-01

    Discussion: The patient required only physical therapy and oral prednisone following surgery for treatment of the neuropraxia. She responded well and has regained significant neuromotor function of the affected limb. Cases presenting with post-resection neurological sequelae without any known intraoperative nerve injury may respond very well to conservative treatment. Hence, it is very important to collaborate with Neurology and Physical Therapy to achieve best possible outcome.

  16. Laparoscopic right colon resection with intracorporeal anastomosis.

    Science.gov (United States)

    Chang, Karen; Fakhoury, Mathew; Barnajian, Moshe; Tarta, Cristi; Bergamaschi, Roberto

    2013-05-01

    This study was performed to evaluate short-term clinical outcomes of laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon. This was a retrospective study of selected patients who underwent laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon for tumors or Crohn's disease by a single surgeon from July 2002 through June 2012. Data were retrieved from an Institutional Review Board-approved database. Study end point was postoperative adverse events, including mortality, complications, reoperations, and readmissions at 30 days. Antiperistaltic side-to-side anastomoses were fashioned laparoscopically with a 60-mm-long stapler cartridge and enterocolotomy was hand-sewn intracorporeally in two layers. Values were expressed as medians (ranges) for continuous variables. There were 243 patients (143 females) aged 61 (range = 19-96) years, with body mass index of 29 (18-43) kg/m(2) and ASA 1:2:3:4 of 52:110:77:4; 30 % had previous abdominal surgery and 38 % had a preexisting comorbidity. There were 84 ileocolic resections with ileo ascending anastomosis and 159 right colectomies with ileotransverse anastomosis. Operating time was 135 (60-220) min. Estimated blood loss was 50 (10-600) ml. Specimen extraction site incision length was 4.1 (3-4.4) cm. Conversion rate was 3 % and there was no mortality at 30 days, 15 complications (6.2 %), and 8 reoperations (3.3 %). Readmission rate was 8.7 %. Length of stay was 4 (2-32) days. Pathology confirmed Crohn's disease in 84 patients, adenocarcinoma in 152, and other tumors in 7 patients. Laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon resulted in a favorable outcome in selected patients with Crohn's disease or tumors of the right colon.

  17. Chest wall resection for multifocal osseous haemangioma.

    Science.gov (United States)

    Weinandt, Marthe; Legras, Antoine; Mordant, Pierre; Le Pimpec Barthes, Françoise

    2016-02-01

    Intraosseous haemangioma is a rare and benign primary tumour of the bone. We report the case of a 76-year old woman who presented the exceptional condition of multifocal cavernous haemangiomas involving the spine and the ribs, requiring spinal and chest wall resections to confirm the diagnosis and treat the symptoms. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Effects of whole-body vibration on muscle architecture, muscle strength, and balance in stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Marín, Pedro J; Ferrero, Cristina M; Menéndez, Héctor; Martín, Juan; Herrero, Azael J

    2013-10-01

    The aim of the present study was to analyze the effects of whole-body vibration on lower limb muscle architecture, muscle strength, and balance in stroke patients during a period of 3 mos. The inclusion criteria were having had ischemic or hemorrhagic stroke at least 6 mos before the study and a National Institutes of Health Stroke Scale score of greater than 1 and less than 20. The patients were randomly divided into two groups: an experimental group (n = 11, six men and five women; age, 62.4 ± 10.7 yrs; height, 1.64 ± 0.07 m; mass, 69.4 ± 12.9 kg) and a sham group (n = 9, five men and four women; age, 64.4 ± 7.6 yrs; height, 1.62 ± 0.07 m; mass, 75.0 ± 15.8 kg). The experimental group received a whole-body vibration treatment, with an increase in frequency, sets, and time per set during 17 sessions. The sham group performed the same exercises as that of the experimental group but was not exposed to vibration. Outcome variables included the muscle architecture (the rectus femoris, the vastus lateralis, and the medial gastrocnemius), the maximal isometric voluntary contraction of the knee extensors, and the Berg Balance Scale. There were no significant differences between the groups on the primary outcomes of lower limb muscle architecture, muscle strength, and balance. It seems that whole-body vibration exercise does not augment the increase in neuromuscular performance and lower limb muscle architecture induced by isometric exercise alone in stroke patients.

  19. Impact-induced soft-tissue vibrations associate with muscle activation in human landing movements: An accelerometry and EMG evaluation.

    Science.gov (United States)

    Fu, Weijie; Wang, Xi; Liu, Yu

    2015-01-01

    Previous studies have not used neurophysiological methodology to explore the damping effects on induced soft-tissue vibrations and muscle responses. This study aimed to investigate the changes in activation of the musculoskeletal system in response to soft-tissue vibrations with different applied compression conditions in a drop-jump landing task. Twelve trained male participants were instructed to perform drop-jump landings in compression shorts (CS) and regular shorts without compression (control condition, CC). Soft-tissue vibrations and EMG amplitudes of the leg within 50 ms before and after touchdown were collected synchronously. Peak acceleration of the thigh muscles was significantly lower in CS than in CC during landings from 45 or 60 cm and 30 cm heights (p soft-tissue vibration damping was associated with a decrease in muscular activity of the rectus femoris and biceps femoris muscles during drop-jump landings from different heights.

  20. Incidental Transient Cortical Blindness after Lung Resection

    Science.gov (United States)

    Oncel, Murat; Sunam, Guven Sadi; Varoglu, Asuman Orhan; Karabagli, Hakan; Yildiran, Huseyin

    2016-01-01

    Transient vision loss after major surgical procedures is a rare clinical complication. The most common etiologies are cardiac, spinal, head, and neck surgeries. There has been no report on vision loss after lung resection. A 65-year-old man was admitted to our clinic with lung cancer. Resection was performed using right upper lobectomy with no complications. Cortical blindness developed 12 hours later in the postoperative period. Results from magnetic resonance imaging and diffusion-weighted investigations were normal. The neurologic examination was normal. The blood glucose level was 92 mg/dL and blood gas analysis showed a PO 2 of 82 mm Hg. After 24 hours, the patient began to see and could count fingers, and his vision was fully restored within 72 hours after this point. Autonomic dysfunction due to impaired microvascular structures in diabetes mellitus may induce posterior circulation dysfunction, even when the hemodynamic state is normal in the perioperative period. The physician must keep in mind that vision loss may occur after lung resection due to autonomic dysfunction, especially in older patients with diabetes mellitus. PMID:28824977

  1. [Total hip endoprosthesis following resection arthroplasty].

    Science.gov (United States)

    Engelbrecht, E; Siegel, A; Kappus, M

    1995-08-01

    From 1976 to December 1994, a total of 347 patients underwent implantation of a hip prosthesis at the ENDO-Klinik for treatment of an unsatisfactory condition following resection arthroplasty. From 1976 to 1987, 143 patients were treated and in 1989 the results obtained in these patients were analysed: 99 of them were available for a follow-up examination in 1989, and 64 for a further examination in 1995. In 130 cases infection had been the reason for joint resection. At the time of the prosthesis operation (1-20 years later) intraoperative biopsy revealed that infection was still present in 41 cases (31.5%). Only 15 of these infections had been detected preoperatively by joint aspiration. This shows that the value of resection arthroplasty as a method of treating periprosthetic infection is limited and lends support to the one-stage exchange operation, which is the method we prefer in cases of infected hip prostheses. The operative technique and preparation for implantation of the prosthesis are described, as are septic and aseptic complications and the measures that can be taken to treat them. In spite of the patients' generally poor initial condition and with due consideration for the further revision operations, the medium-term results finally obtained are poor in only 9%.

  2. Orbitopterional Craniotomy Resection of Pediatric Suprasellar Craniopharyngioma.

    Science.gov (United States)

    LeFever, Devon; Storey, Chris; Guthikonda, Bharat

    2018-04-01

    The orbitopterional approach provides an excellent combination of basal access and suprasellar access. This approach also allows for less brain retraction when resecting larger suprasellar tumors that are more superiorly projecting due to a more frontal and inferior trajectory. In this operative video, the authors thoroughly detail an orbitopterional craniotomy utilizing a one-piece modified orbitozygomatic technique. This technique involves opening the craniotomy through a standard pterional incision. The craniotomy is performed using the standard three burr holes of a pterional approach; however, the osteotomy is extended anteriorly through the frontal process of the zygomatic bone as well as through the supraorbital rim. In this operative video atlas, the authors illustrate the operative anatomy, as well as surgical strategy and techniques to resect a large suprasellar craniopharyngioma in a 4-year-old male. Other reasonable approach options for a lesion of this size would include a standard pterional approach, a supraorbital approach, or expanded endoscopic transsphenoidal approach. The lesion was quite high and thus, the supraorbital approach may confine access to the superior portion of the tumor. While recognizing that some groups may have chosen the endoscopic expanded transsphenoidal approach for this lesion, the authors describe more confidence in achieving the goal of a safe and maximal resection with the orbitopterional approach. The link to the video can be found at: https://youtu.be/eznsK16BzR8 .

  3. Determining gastric cancer resectability by dynamic MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Zilai; Zhang, Huan; Du, Lianjun; Ding, Bei; Song, Qi; Ling, Huawei; Huang, Baisong; Chen, Kemin [Jiaotong University, Department of Radiology, Shanghai (China); Yan, Chao [Jiaotong University, Department of Surgery, Shanghai (China)

    2010-03-15

    Multi-detector row CT (MDCT) has been widely used to detect primary lesions and to evaluate TNM staging. In this study we evaluated the accuracy of dynamic MDCT in the preoperative determination of the resectability of gastric cancer. MDCT was used to image 350 cases of gastric cancer diagnosed by biopsy before surgery. MDCT findings regarding TNM staging and resectability were correlated with surgical and pathological findings. The accuracy of MDCT for staging gastric cancer was high, especially for tumour stage T1 (94.3%), lymph node stage N2 (87.3%), and for predicting distant metastases (>96.6%). When resectability was considered to be the outcome, the total accuracy of MDCT was 87.4%, sensitivity was 89.7% and specificity was 76.7%. Results showed high sensitivity for identifying peritoneal seeding (90.0%) and for predicting liver metastasis (80.0%). Dynamic enhanced MDCT is useful for TNM staging of gastric cancers and for predicting tumour respectability preoperatively. (orig.)

  4. Determining gastric cancer resectability by dynamic MDCT

    International Nuclear Information System (INIS)

    Pan, Zilai; Zhang, Huan; Du, Lianjun; Ding, Bei; Song, Qi; Ling, Huawei; Huang, Baisong; Chen, Kemin; Yan, Chao

    2010-01-01

    Multi-detector row CT (MDCT) has been widely used to detect primary lesions and to evaluate TNM staging. In this study we evaluated the accuracy of dynamic MDCT in the preoperative determination of the resectability of gastric cancer. MDCT was used to image 350 cases of gastric cancer diagnosed by biopsy before surgery. MDCT findings regarding TNM staging and resectability were correlated with surgical and pathological findings. The accuracy of MDCT for staging gastric cancer was high, especially for tumour stage T1 (94.3%), lymph node stage N2 (87.3%), and for predicting distant metastases (>96.6%). When resectability was considered to be the outcome, the total accuracy of MDCT was 87.4%, sensitivity was 89.7% and specificity was 76.7%. Results showed high sensitivity for identifying peritoneal seeding (90.0%) and for predicting liver metastasis (80.0%). Dynamic enhanced MDCT is useful for TNM staging of gastric cancers and for predicting tumour respectability preoperatively. (orig.)

  5. Trunk muscle activation during golf swing: Baseline and threshold.

    Science.gov (United States)

    Silva, Luís; Marta, Sérgio; Vaz, João; Fernandes, Orlando; Castro, Maria António; Pezarat-Correia, Pedro

    2013-10-01

    There is a lack of studies regarding EMG temporal analysis during dynamic and complex motor tasks, such as golf swing. The aim of this study is to analyze the EMG onset during the golf swing, by comparing two different threshold methods. Method A threshold was determined using the baseline activity recorded between two maximum voluntary contraction (MVC). Method B threshold was calculated using the mean EMG activity for 1000ms before the 500ms prior to the start of the Backswing. Two different clubs were also studied. Three-way repeated measures ANOVA was used to compare methods, muscles and clubs. Two-way mixed Intraclass Correlation Coefficient (ICC) with absolute agreement was used to determine the methods reliability. Club type usage showed no influence in onset detection. Rectus abdominis (RA) showed the higher agreement between methods. Erector spinae (ES), on the other hand, showed a very low agreement, that might be related to postural activity before the swing. External oblique (EO) is the first being activated, at 1295ms prior impact. There is a similar activation time between right and left muscles sides, although the right EO showed better agreement between methods than left side. Therefore, the algorithms usage is task- and muscle-dependent. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Modelling of Muscle Force Distributions During Barefoot and Shod Running

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2015-09-01

    Full Text Available Research interest in barefoot running has expanded considerably in recent years, based around the notion that running without shoes is associated with a reduced incidence of chronic injuries. The aim of the current investigation was to examine the differences in the forces produced by different skeletal muscles during barefoot and shod running. Fifteen male participants ran at 4.0 m·s-1 (± 5%. Kinematics were measured using an eight camera motion analysis system alongside ground reaction force parameters. Differences in sagittal plane kinematics and muscle forces between footwear conditions were examined using repeated measures or Freidman’s ANOVA. The kinematic analysis showed that the shod condition was associated with significantly more hip flexion, whilst barefoot running was linked with significantly more flexion at the knee and plantarflexion at the ankle. The examination of muscle kinetics indicated that peak forces from Rectus femoris, Vastus medialis, Vastus lateralis, Tibialis anterior were significantly larger in the shod condition whereas Gastrocnemius forces were significantly larger during barefoot running. These observations provide further insight into the mechanical alterations that runners make when running without shoes. Such findings may also deliver important information to runners regarding their susceptibility to chronic injuries in different footwear conditions.

  7. Muscle reflexes during gait elicited by electrical stimulation of the posterior cruciate ligament in humans

    DEFF Research Database (Denmark)

    Fischer-Rasmussen, T; Krogsgaard, M R; Jensen, D B

    2002-01-01

    over the vastus medialis, rectus femoris, vastus lateralis, biceps femoris caput longum, and semitendinosus muscles. The stimuli consisted of four pulses delivered at 200 Hz; the stimulus amplitude was two to three times the sensory threshold. The electrical stimulation of the PCL inhibited the ongoing......We investigated the influence of electrical stimulation of the posterior cruciate ligament (PCL) on the motoneuron pool of the thigh and calf muscle during gait. The study group comprised eight young men without any history of injury to the knee joints. Multistranded teflon-insulated stainless...... steel wires were inserted into the PCL guided by sonography and in four subjects also into the fat pad of the knee. The PCL was electrically stimulated during gait on a treadmill at heel strike and 100 ms after heel strike. Electromyographic signals were recorded with bipolar surface electrodes placed...

  8. Hepatic resection for colorectal metastases - a national perspective.

    Science.gov (United States)

    Heriot, A. G.; Reynolds, J.; Marks, C. G.; Karanjia, N.

    2004-01-01

    BACKGROUND: Many consultant surgeons are uncertain about peri-operative assessment and postoperative follow-up of patients for colorectal liver metastases, and indications for referral for hepatic resection. The aim of this study was to assess the views the consultant surgeons who manage these patients. METHODS: A postal questionnaire was sent to all consultant members of the Association of Coloproctology of Great Britain and Ireland and of the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland. The questionnaire assessed current practice for preoperative assessment and follow-up of patients with colorectal malignancy and timing of and criteria for hepatic resection of metastases. Number of referrals/resections were also assessed. RESULTS: The response rate was 47%. Half of the consultants held joint clinics with an oncologist and 89% assessed the liver for secondaries prior to colorectal resection. Ultrasound was used by 75%. Whilst 99% would consider referring a patient with a solitary liver metastasis for resection, only 62% would consider resection for more than 3 unilobar metastases. The majority (83%) thought resections should be performed within the 6 months following colorectal resection. During follow-up, 52% requested blood CEA levels and 72% liver ultrasound. Half would consider chemotherapy prior to liver resection and 76% performed at least one hepatic resection per year with a median number of 2 resections each year. CONCLUSIONS: A substantial proportion of patients are assessed for colorectal liver metastases preoperatively and during follow-up though there is spectrum of frequency of assessment and modality for imaging. Virtually all patients with solitary hepatic metastases are considered for liver resection. Patients with more than one metastasis are likely to be not considered for resection. Many surgeons are carrying out less than 3 resections each year. PMID:15527578

  9. [Duodenum-preserving total pancreatic head resection and pancreatic head resection with segmental duodenostomy].

    Science.gov (United States)

    Takada, Tadahiro; Yasuda, Hideki; Nagashima, Ikuo; Amano, Hodaka; Yoshiada, Masahiro; Toyota, Naoyuki

    2003-06-01

    A duodenum-preserving pancreatic head resection (DPPHR) was first reported by Beger et al. in 1980. However, its application has been limited to chronic pancreatitis because of it is a subtotal pancreatic head resection. In 1990, we reported duodenum-preserving total pancreatic head resection (DPTPHR) in 26 cases. This opened the way for total pancreatic head resection, expanding the application of this approach to tumorigenic morbidities such as intraductal papillary mucinous tumor (IMPT), other benign tumors, and small pancreatic cancers. On the other hand, Nakao et al. reported pancreatic head resection with segmental duodenectomy (PHRSD) as an alternative pylorus-preserving pancreatoduodenectomy technique in 24 cases. Hirata et al. also reported this technique as a new pylorus-preserving pancreatoduodenostomy with increased vessel preservation. When performing DPTPHR, the surgeon should ensure adequate duodenal blood supply. Avoidance of duodenal ischemia is very important in this operation, and thus it is necessary to maintain blood flow in the posterior pancreatoduodenal artery and to preserve the mesoduodenal vessels. Postoperative pancreatic functional tests reveal that DPTPHR is superior to PPPD, including PHSRD, because the entire duodenum and duodenal integrity is very important for postoperative pancreatic function.

  10. Effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain.

    Science.gov (United States)

    Yoo, Won-Gyu

    2015-01-01

    [Purpose] We investigated the effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain. [Subject] A 36-year-old female complained of pain in the sacroiliac joints. [Methods] The subject performed individual strengthening exercises for the stabilization muscles for nutation torque of the sacroiliac joint for 3 weeks. Pain-provocation tests and visual analog scale (VAS) scores were evaluated before and after the exercises. [Results] After performing the individual strengthening exercises for the erector spinae, rectus abdominis, and biceps femoris muscles for 3 weeks, the subject displayed no pain in the pain provocation tests, and the VAS score was 2/10. [Conclusion] The individual strengthening exercises for the stabilization muscles of the sacroiliac joint performed in the present study appear to be effective for sedentary workers with sacroiliac joint pain.

  11. Distal splenorenal shunt with partial spleen resection

    Directory of Open Access Journals (Sweden)

    Gajin Predrag

    2007-01-01

    Full Text Available Introduction: Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective. The aim of our study was to present the advantages of distal splenorenal shunt (Warren with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method. From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%, while in the second group there were 13 patients with splenomegaly (68%. Before surgery, the mean platelet count in the first group was 51.6±18.3x109/l, to 118.6±25.4x109/l postoperatively. The mean platelet count in the second group was 67.6±22.8x109/l, to 87.8±32.1x109/l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05. Comparing the

  12. Arthroscopic Talocalcaneal Coalition Resection in Children.

    Science.gov (United States)

    Knörr, Jorge; Soldado, Francisco; Menendez, Mariano E; Domenech, Pedro; Sanchez, Mikel; Sales de Gauzy, Jérôme

    2015-12-01

    To present the technique and outcomes of arthroscopic talocalcaneal coalition (TCC) resection in pediatric patients. We performed a prospective study of 16 consecutive feet with persistent symptomatic TCCs in 15 children. The mean age was 11.8 years (range, 8 to 15 years), and the mean follow-up period was 28 months (range, 12 to 44 months). A posterior arthroscopic TCC resection was performed. The plantar footprint, subtalar motion, pain, and the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scale score were evaluated preoperatively and postoperatively. Preoperative computed tomography (CT) scans were used to classify the coalition according to the Rozansky classification, to measure the percentage of involvement of the surface area, and to determine the degree of hindfoot valgus. Postoperative CT scans at 1 year (n = 15) and 3 years (n = 5) were used to assess recurrences. Patient satisfaction was also evaluated. The TCC distribution according to the Rozansky classification was type I in 7 cases, type II in 3, type III in 3, and type IV in 3. In all cases the arthroscopic approach enabled complete coalition resection. All patients increased by at least 1 stage in the footprint classification and showed clinical subtalar mobility after surgery. All patients showed a statistically significant improvement in pain after surgery except for 1 patient in whom complex regional pain syndrome developed (P < .001). The mean American Orthopaedic Foot & Ankle Society score was 56.8 (range, 45 to 62) preoperatively versus 90.9 (range, 36 to 100) postoperatively, showing a statistically significant increase (P < .001). Preoperative CT scans showed that all TCCs involved the medial subtalar joint facet, with mean involvement of 40.8% of the articular surface. All postoperative CT scans showed complete synostosis resections with no recurrences at final follow-up. At final follow-up, all patients were either satisfied (n = 4 [27%]) or extremely satisfied (n = 10 [67

  13. Surgical resection of synchronously metastatic adrenocortical cancer.

    Science.gov (United States)

    Dy, Benzon M; Strajina, Veljko; Cayo, Ashley K; Richards, Melanie L; Farley, David R; Grant, Clive S; Harmsen, William S; Evans, Doug B; Grubbs, Elizabeth G; Bible, Keith C; Young, William F; Perrier, Nancy D; Que, Florencia G; Nagorney, David M; Lee, Jeffrey E; Thompson, Geoffrey B

    2015-01-01

    Metastatic adrenocortical carcinoma (ACC) is rapidly fatal, with few options for treatment. Patients with metachronous recurrence may benefit from surgical resection. The survival benefit in patients with hematogenous metastasis at initial presentation is unknown. A review of all patients undergoing surgery (European Network for the Study of Adrenal Tumors) stage IV ACC between January 2000 and December 2012 from two referral centers was performed. Kaplan-Meier estimates were analyzed for disease-free and overall survival (OS). We identified 27 patients undergoing surgery for stage IV ACC. Metastases were present in the lung (19), liver (11), and brain (1). A complete resection (R0) was achieved in 11 patients. The median OS was improved in patients undergoing R0 versus R2 resection (860 vs. 390 days; p = 0.02). The 1- and 2-year OS was also improved in patients undergoing R0 versus R2 resection (69.9 %, 46.9 % vs. 53.0 %, 22.1 %; p = 0.02). Patients undergoing neoadjuvant therapy (eight patients) had a trend towards improved survival at 1, 2, and 5 years versus no neoadjuvant therapy (18 patients) [83.3 %, 62.5 %, 41.7 % vs. 56.8 %, 26.6 %, 8.9 %; p = 0.1]. Adjuvant therapy was associated with improved recurrence-free survival at 6 months and 1 year (67 %, 33 % vs. 40 %, 20 %; p = 0.04) but not improved OS (p = 0.63). Sex (p = 0.13), age (p = 0.95), and location of metastasis (lung, p = 0.51; liver, p = 0.67) did not correlate with OS after operative intervention. Symptoms of hormonal excess improved in 86 % of patients. Operative intervention, especially when an R0 resection can be achieved, following systemic therapy may improve outcomes, including OS, in select patients with stage IV ACC. Response to neoadjuvant chemotherapy may be of use in defining which patients may benefit from surgical intervention. Adjuvant therapy was associated with decreased recurrence but did not improve OS.

  14. MRI image characteristics of materials implanted at sellar region after transsphenoidal resection of pituitary tumours

    International Nuclear Information System (INIS)

    Bladowska, J.; Sasiadek, M.; Bednarek-Tupikowska, G.; Sokolska, V.; Badowski, R.; Moron, K.; Bonicki, W.

    2010-01-01

    Background: Post-surgical evaluation of the pituitary gland in MRI is difficult because of a change in anatomical conditions. It depends also on numerous other factors, including: size and expansion of the tumour before surgery, type of surgical access, quality and volume of implanted materials and time of its resorption. The purpose was to demonstrate the characteristics of the implanted materials on MRI performed after transsphenoidal resection of pituitary tumours and to identify imaging criteria helpful in differential diagnosis of masses within the sellar region. Material/Methods: One hundred and fifty-four patients after transsphenoidal resection of pituitary tumours were included in the study. In general, 469 MRI examinations were performed with a 1.5 T scanner. We obtained T1-weighted sagittal and coronal, enhanced and unenhanced images. In 102 cases, additional T2-weighted coronal, unenhanced images with 1.5 T unit were obtained as well. Results: The implanted materials appeared in 95 patient: fat in 86 and muscle with fascia in 3 patients. We could recognise implanted muscle and fascia in T2-weighted images, because of high signal intensity of the degenerating muscle and the line of low signal representing fascia. The implanted titanium mesh was found in 4 patients. Haemostatic materials were visible only in 2 patients in examinations performed at an early postoperative stage (1 month after the procedure). Conclusions: The knowledge of MRI characteristics of the materials implanted at the sellar region is very important in postoperative diagnosis of pituitary tumours and may help discriminate between tumorous and non-tumorous involvement of the sellar region. Some implanted materials, like fat, could be seen on MRI for as long as 10 years after the operation, others, like haemostatic materials, for only 1 month after surgery. T2-weighted imaging is a useful assessment method of the implanted muscle and fascia for a long time after surgery. (authors)

  15. Sarcopenia is a predictive factor for intestinal resection in admitted patients with Crohn's disease.

    Directory of Open Access Journals (Sweden)

    Shigeki Bamba

    Full Text Available The relationship between skeletal muscle volume and the prognosis of patients with inflammatory bowel disease (IBD remains undetermined. We conducted a retrospective study of 72 IBD patients who were admitted to the hospital due to disease exacerbation. We enrolled IBD patients who had undergone abdominal computed tomography and assessed the nutritional indices, such as the Onodera's prognostic nutritional index (O-PNI and the controlling nutritional status (CONUT index. The L3 skeletal muscle index (SMI, which is the ratio of the cross-sectional area of skeletal muscles at the level of the third lumbar (L3 vertebra to the height squared, was used to identify sarcopenia. Sarcopenia, defined as a low SMI, was observed in 42% of all IBD patients (37% with Crohn's disease (CD and 48% with ulcerative colitis (UC. In UC patients, the O-PNI and CONUT values, height, and albumin levels were significantly lower than in CD patients. The SMI strongly correlated with sex, body weight, albumin level, and O-PNI in IBD patients. Multivariate analysis using the Cox regression model demonstrated that the presence of sarcopenia (P = 0.015 and disease type (CD or UC (P = 0.007 were significant factors predicting intestinal resection. The cumulative operation-free survival rate was significantly lower for sarcopenic patients than in all IBD patients (P = 0.003 and a stratified analysis of CD patients (P = 0.001 using the Kaplan-Meier method and log-rank test. The L3 skeletal muscle area is a prognostic factor for intestinal resection in patients with CD.

  16. Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking.

    Science.gov (United States)

    Attias, M; Bonnefoy-Mazure, A; De Coulon, G; Cheze, L; Armand, S

    2016-10-01

    Contracture is a permanent shortening of the muscle-tendon-ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking. An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus). Sixteen combinations of contractures were emulated on the unilateral and bilateral muscles of nine healthy participants. Two sessions of gait analysis were performed at weekly intervals to assess the reliability of the emulated contractures. Discrete variables were extracted from the kinematics to analyse the reliability. The exoskeleton did not affect normal walking when contractures were not emulated. Kinematic reliability varied from poor to excellent depending on the targeted muscle. Reliability was good for the bilateral and unilateral gastrocnemius, soleus, and tibialis posterior as well as the bilateral hamstring and unilateral hip adductors. The exoskeleton can be used to replicate contracture on healthy participants. The exoskeleton will allow us to differentiate primary and compensatory effects of muscle contractures on gait kinematics. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. A new approach to assess the spasticity in hamstrings muscles using mechanomyography antagonist muscular group.

    Science.gov (United States)

    Krueger, Eddy; Scheeren, Eduardo M; Nogueira-Neto, Guilherme N; Button, Vera Lúcia da S N; Nohama, Percy

    2012-01-01

    Several pathologies can cause muscle spasticity. Modified Ashworth scale (MAS) can rank spasticity, however its results depend on the physician subjective evaluation. This study aims to show a new approach to spasticity assessment by means of MMG analysis of hamstrings antagonist muscle group (quadriceps muscle). Four subjects participated in the study, divided into two groups regarding MAS (MAS0 and MAS1). MMG sensors were positioned over the muscle belly of rectus femoris (RF), vastus lateralis (VL) and vastus medialis (VM) muscles. The range of movement was acquired with an electrogoniometer placed laterally to the knee. The system was based on a LabVIEW acquisition program and the MMG sensors were built with triaxial accelerometers. The subjects were submitted to stretching reflexes and the integral of the MMG (MMG(INT)) signal was calculated to analysis. The results showed that the MMG(INT) was greater to MAS1 than to MAS0 [muscle RF (p = 0.004), VL (p = 0.001) and VM (p = 0.007)]. The results showed that MMG was viable to detect a muscular tonus increase in antagonist muscular group (quadriceps femoris) of spinal cord injured volunteers.

  18. Growth hormone mitigates loss of periosteal bone formation and muscle mass in disuse osteopenic rats.

    Science.gov (United States)

    Grubbe, M-C; Thomsen, J S; Nyengaard, J R; Duruox, M; Brüel, A

    2014-12-01

    Growth hormone (GH) is a potent anabolic agent capable of increasing both bone and muscle mass. The aim was to investigate whether GH could counteract disuse-induced loss of bone and muscle mass in a rat model. Paralysis was induced by injecting 4 IU Botox (BTX) into the muscles of the right hind limb. Sixty female Wistar rats, 14 weeks old, were divided into the following groups: baseline, controls, BTX, BTX+GH, and GH. GH was given at a dosage of 5 mg/kg/d for 4 weeks. Compared with controls, BTX resulted in lower periosteal bone formation rate (BFR/BS,-79%, Pbone mineral density (aBMD, -13%, Pbone volume (BV/TV, -26%, Pbone strength (-12%, Pbone strength was found. In addition, GH partly prevented loss of muscle mass (+29% vs. BTX, P<0.001), and tended to prevent loss of muscle CSA (+11%, P=0.064). In conclusion, GH mitigates disuse-induced loss of periosteal BFR/BS at the mid-femur and rectus femoris muscle mass.

  19. Parenteral corticosteroids followed by early surgical resection of large amblyogenic eyelid hemangiomas in infants

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    El Essawy R

    2013-05-01

    Full Text Available Rania El Essawy,1 Rasha Essameldin Galal21Department of Ophthalmology, 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptBackground: The purpose of this study was to evaluate the results and complications of early surgical resection of large amblyogenic subdermal eyelid hemangiomas in infants after prior short-term parenteral administration of corticosteroids.Methods: Sixteen infants were given dexamethasone 2 mg/kg/day in two divided doses for three consecutive days prior to scheduled surgical excision of large eyelid hemangiomas. The lesions were accessed via an upper eyelid crease, subeyebrow incision, or a lower eyelid subciliary incision.Results: In all cases, surgical excision of the entire lesion was possible with no significant intraoperative or postoperative complications. The levator muscle/aponeurosis complex was involved in 31.25% of cases and was managed by reinsertion or repositioning without resection. A satisfactory lid position and contour with immediate clearing of the visual axis was achieved in all but one case (93.8%.Conclusion: Parenteral corticosteroids helped in reducing volume and blood flow from the hemangiomas, allowing for very early total excision of large subdermal infantile hemangiomas without significant intraoperative hemorrhage. This resulted in immediate elimination of any reason for occlusion amblyopia. Long-term follow-up of visual development in these patients would help to demonstrate the effectiveness of this strategy compared with more conservative measures.Keywords: large eyelid hemangiomas, early surgical resection, parenteral corticosteroids

  20. Predictive images of postoperative levator resection outcome using image processing software

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    Mawatari Y

    2016-09-01

    Full Text Available Yuki Mawatari,1 Mikiko Fukushima2 1Igo Ophthalmic Clinic, Kagoshima, 2Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Chuo-ku, Kumamoto, Japan Purpose: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection.Methods: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller’s muscle complex (levator resection. Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop®. Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery.Results: Approximately 1 month postoperatively, we surveyed our patients using questionnaires. Fifty-six patients (89.2% were satisfied with their postoperative appearances, and 55 patients (84.8% positively responded to the usefulness of processed images to predict postoperative appearance.Conclusion: Showing processed images that predict postoperative appearance to patients prior to blepharoptosis surgery can be useful for those patients concerned with their postoperative appearance. This approach may serve as a useful tool to simulate blepharoptosis surgery. Keywords: levator resection, blepharoptosis, image processing, Adobe Photoshop® 

  1. Agreement between intraoperative measurements and optical coherence tomography of the limbus-insertion distance of the extraocular muscles.

    Science.gov (United States)

    de-Pablo-Gómez-de-Liaño, L; Fernández-Vigo, J I; Ventura-Abreu, N; Morales-Fernández, L; García-Feijóo, J; Gómez-de-Liaño, R

    2016-12-01

    To assess the agreement between intraoperative measurements of the limbus-insertion distance of the extraocular muscles with those measured by spectral domain optical coherence tomography. An analysis was made of a total of 67 muscles of 21 patients with strabismus. The limbus-insertion distance of the horizontal rectus muscles were measured using pre-operative SD-OCT and intra-operatively in 2 ways: 1) direct, after a conjunctival dissection in patients who underwent surgery, or 2) transconjunctival in patients who were treated with botulinum toxin, or in those who were not going to be operated. The intraclass correlation coefficient and Bland-Altman plots were calculated to determine the concordance between the 2 methods. The mean age was 45.9 ±20.9 years (range 16 to 85), with 52% being women. The percentage of identification by direct intraoperative measurement was 95.6% (22/23), by transconjunctival intraoperative measurement 90.9% (40/44), and by OCT 85% (57/67), with 22 muscles finally being analysed for the agreement study between direct intraoperative measurement and OCT measurements, and 35 muscles for the agreement between transconjuctival intraoperative measurement and OCT. The intraclass correlation coefficient showed good agreement with OCT and direct intraoperative measurements (0.931; 95% confidence interval (95% CI): 0.839-0.972; P<.001), and with transconjunctival intraoperative measurements (0.889; 95% CI: 0.790-0.942; P<.001). The SD-OCT is an effective technique to measure the distance from the insertion of the horizontal rectus muscles to the limbus, with a high agreement with intraoperative measurements being demonstrated. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Trans rectus sheath extra-peritoneal procedure (TREPP) for inguinal hernia: the first 1,000 patients.

    Science.gov (United States)

    Lange, J F M; Lange, M M; Voropai, D A; van Tilburg, M W A; Pierie, J P E N; Ploeg, R J; Akkersdijk, W L

    2014-08-01

    After the introduction of mesh in inguinal hernia repair, the focus to improve surgical technique has changed from recurrence to chronic postoperative inguinal pain. At present, the most common surgical techniques are the Lichtenstein hernioplasty and total extraperitoneal procedure. Both techniques have their own specific disadvantages, with regard to potential nerve damage and the necessity of general anesthesia, respectively. The goal of this study was to evaluate the results of a new technique in which the inguinal nerves are not at risk, and in which general anesthesia is not needed: trans rectus sheath extraperitoneal procedure (TREPP). Between 2006 and 2010, a total of 1,000 patients were treated for inguinal hernia with TREPP. A questionnaire concerning pain, sensibility changes, patient satisfaction, and recurrence was sent to all patients. The questionnaire was completed by 932 patients. Almost 90% of patients had not experienced any pain since the surgical procedure; 8% of patients reported experiencing some pain, but less than preoperatively; and 2% of patients reported an increase in pain postoperatively. Recurrence occurred in 1 and 3% were unsure about this. Reduced sensibility of the scar, scrotum, and upper leg was reported by 12.4, 1.4, and 1.5%, respectively. Overall, 97.4% of patients were satisfied with the results of the surgical procedure. The time period in which TREPP was performed was not associated with any of the outcome measures. TREPP has proven to be a feasible new technique for inguinal hernia repair, with excellent results, justifying a randomized controlled trial in which TREPP should be compared with standard techniques.

  3. The effects of surface condition on abdominal muscle activity during single-legged hold exercise.

    Science.gov (United States)

    Ha, Sung-min; Oh, Jae-seop; Jeon, In-cheol; Kwon, Oh-yun

    2015-02-01

    To treat low-back pain, various spinal stability exercises are commonly used to improve trunk muscle function and strength. Because human movement for normal daily activity occurs in multi-dimensions, the importance of exercise in multi-dimensions or on unstable surfaces has been emphasized. Recently, a motorized rotating platform (MRP) for facilitating multi-dimensions dynamic movement was introduced for clinical use. However, the abdominal muscle activity with this device has not been reported. The purpose of this study was to compare the abdominal muscle activity (rectus abdominis, external and internal oblique muscles) during an active single-leg-hold (SLH) exercise on a floor (stable surface), foam roll, and motorized rotating platform (MRP). Thirteen healthy male subjects participated in this study. Using electromyography, the abdominal muscle activity was measured while the subjects performed SLH exercises on floor (stable surface), foam roll, and MRP. There were significant differences in the abdominal muscle activities among conditions (P.05) (Fig. 2). After the Bonferroni correction, however, no significant differences among conditions remained, except for differences in both side IO muscle activity between the floor and foam roll conditions (padjexercises on a foam roll and MRP is more effective increased activities of both side of RA and IO, and Rt. EO compared to floor condition. However, there were no significant differences in abdominal muscles activity in the multiple comparison between conditions (mean difference were smaller than the standard deviation in the abdominal muscle activities) (padj>0.017), except for differences in both side IO muscle activity between the floor (stable surface) and foam roll (padj<0.017) (effect size: 0.79/0.62 (non-supporting/supporting leg) for foam-roll versus floor). Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Association Between Muscle Wasting and Muscle Strength in Patients WHO Developed Severe Sepsis and Septic Shock.

    Science.gov (United States)

    Borges, Rodrigo Cerqueira; Soriano, Francisco Garcia

    2018-05-11

    To evaluate the association between the rectus femoris cross-sectional area (RFCSA) and the muscular strength obtained at the bedside in patients forwarded to the intensive care unit (ICU) for severe sepsis and septic shock. A prospective cohort study. RFCSA was assessed by ultrasound on the following day of the ICU admission and monitored during hospitalization. The patients performed clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip dynamometry), when they could understand the verbal commands of the examiners. In 37 patients hospitalized for sepsis there was a significant decline in RFCSA of 5.18 (4.49-5.96)cm on the 2nd day of ICU for 4.37 (3.71-5.02)cm at hospital discharge. Differently, the handgrip strength showed an increase from the awakening of 12.00 (7.00-20.00)Kgf to 19.00 (14.00-26.00)Kgf until hospital discharge. Patients in mechanical ventilation had a greater tendency to decline in the RFCSA compared to patients who did not receive mechanical ventilation, however without being significant (p = 0.08). There was a negative association between RFCSA delta (2nd day of ICU - ICU discharge) and handgrip strength (r = 0.51, p < 0.05), and a male and SOFA score positive association with the RFCSA delta. There was an association of RFCSA with clinical muscle strength tests. In addition, it has been shown that sepsis can lead to short-term muscle degradation, regardless of whether they are submitted to mechanical ventilation or not.

  5. Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate

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    Guan Hee Tan

    2017-05-01

    Full Text Available Purpose: This study aimed to determine the urethral stricture (US rate and identify clinical and surgical risk factors associated with US occurrence after transurethral resection of the prostate using the bipolar Gyrus PlasmaKinetic Tissue Management System (PKTURP. Materials and Methods: This was an age-matched case-control study of US occurrence after PK-TURP. Retrospective data were collected from the hospital records of patients who had a minimum of 36 months of follow-up information. Among the data collected for analysis were prostate-specific antigen level, estimated prostate weight, the amount of prostate resected, operative time, history of urinary tract infection, previous transurethral resection of the prostate, and whether the PK-TURP was combined with other endourological procedures. The resection rate was calculated from the collected data. Univariate and multivariate analyses were performed to identify clinical and surgical risk factors related to US formation. Results: A total of 373 patients underwent PK-TURP between 2003 and 2009. There were 13 cases of US (3.5%, and most of them (10 of 13, 76.9% presented within 24 months of surgery. Most of the US cases (11 of 13, 84.6% occurred at the bulbar urethra. Multivariable logistic regression analyses identified slow resection rate as the only risk factor significantly associated with US occurrence. Conclusions: The US rate of 3.5% after PK-TURP in this study is comparable to contemporary series. A slow resection rate seems to be related to US occurrence. This should be confirmed by further studies; meanwhile, we must be mindful of this possibility when operating with the PK-TURP system.

  6. Role of hilar resection in the treatment of hilar cholangiocarcinoma.

    Science.gov (United States)

    Otani, Kazuhiro; Chijiiwa, Kazuo; Kai, Masahiro; Ohuchida, Jiro; Nagano, Motoaki; Kondo, Kazuhiro

    2012-05-01

    The aim of this study was to clarify the role of bile duct resection without hepatectomy (hilar resection) in hilar cholangiocarcinoma. We retrospectively compared surgical results for hilar cholangiocarcinoma between 8 patients treated with hilar resection and 21 patients treated with hepatectomy. All hilar resections were performed for Bismuth type I or II tumors with T2 or less lesions, whereas hepatectomy was done for type III or IV tumors excluding one type II tumor. R0 resection was equally achieved in both groups (62.5% in hilar resection group and 76.2% in hepatectomy group, p=0.469) and overall 5-year survival rates were comparable (21.9% vs. 23.6%, p=0.874). With respect to gross tumor appearance, R0 resection was achieved in all patients with papillary tumor in both groups with the excellent 5-year survivals (100% vs. 100%). In patients with nodular and flat tumors, R0 resection was achieved less frequently in the hilar resection vs. hepatectomy group (50% vs. 77.8%) mainly due to failure to clear the proximal ductal margin, resulting in poorer 5-year survival (0% vs. 18.7%). Hilar resection may be indicated for papillary T1 or 2 tumors in Bismuth type I or II cholangiocarcinoma.

  7. 3D Modelling and monitoring of denervated muscle under Functional Electrical Stimulation treatment and associated bone structural changes

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    Paolo Gargiulo

    2011-03-01

    Full Text Available A novel clinical rehabilitation method for patients who have permanent and non recoverable muscle denervation in the legs was developed in the frame of the European Project RISE. The technique is based on FES and the project results shows, in these severely disabled patients, restoration of muscle tissue and function. This study propose novel methods based on image processing technique and medical modelling to monitor growth in denervated muscle treated with FES. Geometrical and structural changes in muscle and bone are studied and modelled. Secondary effects on the bone mineral density produced by the stimulation treatment and due the elicited muscle contraction are also investigated. The restoration process in DDM is an important object of discussion since there isn’t yet a complete understanding of the mechanisms regulating growth in denervated muscle. This study approaches the problem from a macroscopic point of view, developing 3-dimensional models of the whole stimulated muscles and following changes in volume, geometry and density very accurately. The method is based on the acquisition of high resolution Spiral CT scans from patients who have long-term flaccid paraplegia and the use of special image processing tools allowing tissue discriminations and muscle segmentation. Three patients were measured at different points of time during 4 years of electrical stimulation treatment. In this study is quantitatively demonstrated the influences of FES treatment on the different quadriceps bellies. The rectus femoris muscle is positioned in the middle of the quadriceps and responds (in general better to stimulation. In a patient with abundant adipose tissue surrounding the quadriceps, rectus femoris almost doubled the volume during the FES treatment while in the other bellies the changes measured were minimal. The analysis of the density shows clearly a restoration of the muscular structure in the growing muscle. The remarkable increase of

  8. Lower Extremity Muscle Activity During a Women's Overhand Lacrosse Shot

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    Millard Brianna M.

    2014-07-01

    Full Text Available The purpose of this study was to describe lower extremity muscle activity during the lacrosse shot. Participants (n=5 females, age 22±2 years, body height 162.6±15.2 cm, body mass 63.7±23.6 kg were free from injury and had at least one year of lacrosse experience. The lead leg was instrumented with electromyography (EMG leads to measure muscle activity of the rectus femoris (RF, biceps femoris (BF, tibialis anterior (TA, and medial gastrocnemius (GA. Participants completed five trials of a warm-up speed shot (Slow and a game speed shot (Fast. Video analysis was used to identify the discrete events defining specific movement phases. Full-wave rectified data were averaged per muscle per phase (Crank Back Minor, Crank Back Major, Stick Acceleration, Stick Deceleration. Average EMG per muscle was analyzed using a 4 (Phase x 2 (Speed ANOVA. BF was greater during Fast vs. Slow for all phases (p0.05. RF and GA were each influenced by the interaction of Phase and Speed (p<0.05 with GA being greater during Fast vs. Slow shots during all phases and RF greater during Crank Back Minor and Major as well as Stick Deceleration (p<0.05 but only tended to be greater during Stick Acceleration (p=0.076 for Fast vs. Slow. The greater muscle activity (BF, RF, GA during Fast vs. Slow shots may have been related to a faster approach speed and/or need to create a stiff lower extremity to allow for faster upper extremity movements.

  9. Laparoscopic resection of lower rectal cancer with telescopic anastomosis without abdominal incisions.

    Science.gov (United States)

    Li, Shi-Yong; Chen, Gang; Du, Jun-Feng; Chen, Guang; Wei, Xiao-Jun; Cui, Wei; Zuo, Fu-Yi; Yu, Bo; Dong, Xing; Ji, Xi-Qing; Yuan, Qiang

    2015-04-28

    To assess laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions. From March 2010 to June 2014, 30 patients (14 men and 16 women, aged 36-78 years, mean age 59.8 years) underwent laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through anus-preserving transanal resection. The tumors were 5-7 cm away from the anal margin in 24 cases, and 4 cm in six cases. In preoperative assessment, there were 21 cases of T1N0M0 and nine of T2N0M0. Through the middle approach, the sigmoid mesentery was freed at the root with an ultrasonic scalpel and the roots of the inferior mesenteric artery and vein were dissected, clamped and cut. Following the total mesorectal excision principle, the rectum was separated until the anorectal ring reached 3-5 cm from the distal end of the tumor. For perineal surgery, a ring incision was made 2 cm above the dentate line, and sharp dissection was performed submucosally towards the superior direction, until the plane of the levator ani muscle, to transect the rectum. The rectum and distal sigmoid colon were removed together from the anus, followed by a telescopic anastomosis between the full thickness of the proximal colon and the mucosa and submucosal tissue of the rectum. For the present cohort of 30 cases, the mean operative time was 178 min, with an average of 13 positive lymph nodes detected. One case of postoperative anastomotic leak was observed, requiring temporary colostomy, which was closed and recovered 3 mo later. The postoperative pathology showed T1-T2N0M0 in 19 cases and T2N1M0 in 11 cases. Twelve months after surgery, 94.4% patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. The patients were followed up for 1-36 mo, with an average of 23 mo. There was no local recurrence, and 17 patients survived for > 3 years (with a survival rate of 100%). Laparoscopic radical

  10. Extraocular muscle function testing

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003397.htm Extraocular muscle function testing To use the sharing features on this page, please enable JavaScript. Extraocular muscle function testing examines the function of the eye muscles. ...

  11. Short term benefits for laparoscopic colorectal resection.

    Science.gov (United States)

    Schwenk, W; Haase, O; Neudecker, J; Müller, J M

    2005-07-20

    Colorectal resections are common surgical procedures all over the world. Laparoscopic colorectal surgery is technically feasible in a considerable amount of patients under elective conditions. Several short-term benefits of the laparoscopic approach to colorectal resection (less pain, less morbidity, improved reconvalescence and better quality of life) have been proposed. This review compares laparoscopic and conventional colorectal resection with regards to possible benefits of the laparoscopic method in the short-term postoperative period (up to 3 months post surgery). We searched MEDLINE, EMBASE, CancerLit, and the Cochrane Central Register of Controlled Trials for the years 1991 to 2004. We also handsearched the following journals from 1991 to 2004: British Journal of Surgery, Archives of Surgery, Annals of Surgery, Surgery, World Journal of Surgery, Disease of Colon and Rectum, Surgical Endoscopy, International Journal of Colorectal Disease, Langenbeck's Archives of Surgery, Der Chirurg, Zentralblatt für Chirurgie, Aktuelle Chirurgie/Viszeralchirurgie. Handsearch of abstracts from the following society meetings from 1991 to 2004: American College of Surgeons, American Society of Colorectal Surgeons, Royal Society of Surgeons, British Assocation of Coloproctology, Surgical Association of Endoscopic Surgeons, European Association of Endoscopic Surgeons, Asian Society of Endoscopic Surgeons. All randomised-controlled trial were included regardless of the language of publication. No- or pseudorandomised trials as well as studies that followed patient's preferences towards one of the two interventions were excluded, but listed separately. RCT presented as only an abstract were excluded. Results were extracted from papers by three observers independently on a predefined data sheet. Disagreements were solved by discussion. 'REVMAN 4.2' was used for statistical analysis. Mean differences (95% confidence intervals) were used for analysing continuous variables. If

  12. Harlequin Syndrome Following Resection of Mediastinal Ganglioneuroma

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    Yeong Jeong Jeon

    2017-04-01

    Full Text Available Harlequin syndrome is a rare disorder of the sympathetic nervous system characterized by unilateral facial flushing and sweating. Although its etiology is unknown, this syndrome appears to be a dysfunction of the autonomic nervous system. To the best of our knowledge, thus far, very few reports on perioperative Harlequin syndrome after thoracic surgery have been published in the thoracic surgical literature. Here, we present the case of a 6-year-old patient who developed this unusual syndrome following the resection of a posterior mediastinal mass.

  13. Tracheal resection and anastomosis in dogs.

    Science.gov (United States)

    Lau, R E; Schwartz, A; Buergelt, C D

    1980-01-15

    Resection and end-to-end anastomosis of the trachea is a practical procedure for the correction of various forms of tracheal stenosis. Preplacing retention sutures facilitates manipulation of the trachea and rapid apposition of the tracheal ends. These same sutures then relieve tension on the primary suture line, assuring early epithelialization. Two dogs with tracheal stenosis were treated by use of this technique. Slight narrowing of the trachea was evident postoperatively in both dogs, but neither dyspnea nor coughing occurred during the follow-up period.

  14. Transrectal Mesh Erosion Requiring Bowel Resection.

    Science.gov (United States)

    Kemp, Marta Maria; Slim, Karem; Rabischong, Benoît; Bourdel, Nicolas; Canis, Michel; Botchorishvili, Revaz

    To report a case of a transrectal mesh erosion as complication of laparoscopic promontofixation with mesh repair, necessitating bowel resection and subsequent surgical interventions. Sacrocolpopexy has become a standard procedure for vaginal vault prolapse [1], and the laparoscopic approach has gained popularity owing to more rapid recovery and less morbidity [2,3]. Mesh erosion is a well-known complication of surgical treatment for prolapse as reported in several negative evaluations, including a report from the US Food and Drug Administration in 2011 [4]. Mesh complications are more common after surgeries via the vaginal approach [5]; nonetheless, the incidence of vaginal mesh erosion after laparoscopic procedures is as high as 9% [6]. The incidence of transrectal mesh exposure after laparoscopic ventral rectopexy is roughly 1% [7]. The diagnosis may be delayed because of its rarity and variable presentation. In addition, polyester meshes, such as the mesh used in this case, carry a higher risk of exposure [8]. A 57-year-old woman experiencing genital prolapse, with the cervix classified as +3 according to the Pelvic Organ Prolapse Quantification system, underwent laparoscopic standard sacrocolpopexy using polyester mesh. Subtotal hysterectomy and bilateral adnexectomy were performed concomitantly. A 3-year follow-up consultation demonstrated no signs or symptoms of erosion of any type. At 7 years after the surgery, however, the patient presented with rectal discharge, diagnosed as infectious rectocolitis with the isolation of Clostridium difficile. She underwent a total of 5 repair surgeries in a period of 4 months, including transrectal resection of exposed mesh, laparoscopic ablation of mesh with digestive resection, exploratory laparoscopy with abscess drainage, and exploratory laparoscopy with ablation of residual mesh and transverse colostomy. She recovered well after the last intervention, exhibiting no signs of vaginal or rectal fistula and no recurrence

  15. [Resection margins in conservative breast cancer surgery].

    Science.gov (United States)

    Medina Fernández, Francisco Javier; Ayllón Terán, María Dolores; Lombardo Galera, María Sagrario; Rioja Torres, Pilar; Bascuñana Estudillo, Guillermo; Rufián Peña, Sebastián

    2013-01-01

    Conservative breast cancer surgery is facing a new problem: the potential tumour involvement of resection margins. This eventuality has been closely and negatively associated with disease-free survival. Various factors may influence the likelihood of margins being affected, mostly related to the characteristics of the tumour, patient or surgical technique. In the last decade, many studies have attempted to find predictive factors for margin involvement. However, it is currently the new techniques used in the study of margins and tumour localisation that are significantly reducing reoperations in conservative breast cancer surgery. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  16. PPARβ expression in rectus abdominis and abdominal subcutaneous fat of patients with gestational diabetes mellitus and its relationship with glucolipid metabolism

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    Xiao-Yan Zhang

    2017-01-01

    Full Text Available Objective: To study the relationship between peroxisome proliferator-activated receptor β (PPARβ expression in rectus abdominis as well as abdominal subcutaneous fat of patients with gestational diabetes mellitus (GDM and glucolipid metabolism. Methods: The pregnant women who received routine antenatal care and planned to receive selective caesarean section in Obstetrics Department of our hospital between May 2012 and March 2016 were retrospectively analyzed, and 74 healthy pregnant women and 58 pregnant women with GDM were screened and included in the control group and gestational diabetes mellitus group (GDM group respectively. Rectus abdominis and abdominal subcutaneous fat were collected during Cesarean section to determine the expression of PPARβ was measured; peripheral blood was collected at middle-late pregnancy to determine the content of blood glucose metabolism and lipid metabolism indexes as well as adipocytokines. Results: PARβ mRNA expression and protein expression in rectus abdominis and abdominal subcutaneous fat of GDM group were significantly lower than those of control group (P<0.05; homeostasis model assessment insulin secretion index (HOMA-β, homeostasis model assessment insulin resistance (HOMA-IR and OGTT glucose curve (AUCG levels as well as serum low-density lipoprotein cholesterol (LDL-C, triglyceride (TG, cholesterol (TC, Leptin, Resistin and Chemerin content of GDM group were significantly higher than those of control group (P<0.05 while early insulin secretion index (ΔI30/ΔG30 and insulin sensitive index composite (ISIcomp levels as well as serum high-density lipoprotein cholesterol (HDL-C, Omentin-1 and Omentin-1 and adiponectin (ADPN content were significantly lower than those of control group (P<0.05; PARβ mRNA expression and protein expression were negatively correlated with HOMA-β, HOMA IR, area under the AUCG, LDL-C, TG, TC, Leptin, Resistin and Chemerin, and positively correlated with ΔI30/

  17. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    Directory of Open Access Journals (Sweden)

    Andrew D. Vigotsky

    2015-09-01

    Full Text Available Background. Foam rolling has been shown to acutely increase range of motion (ROM during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated.Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61; z(22 = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72 was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75; t(22 = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29 or rectus femoris length (change = −0.005 (−0.013, +0.003; t(22 = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16 were not due to chance alone.Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  18. [On the recurrence risk with partial larynx resections (author's transl)].

    Science.gov (United States)

    Flach, M

    1978-06-01

    28 cases of recurrences after 127 vertical and horizontal partial larynx resections (22 per cent) were analysed. Unfavourable preconditions for partial resections are the affliction of the ary cartilage and arrest of vocal chord movility. The hemiresections according to Hautant have the heighest recidivation percentage (40 per cent) judging from the observations available. Radical operations after failured partial resections are uncertain as to their prognoses.

  19. Curative resection of transverse colon cancer via minilaparotomy.

    Science.gov (United States)

    Ishida, Hideyuki; Ishiguro, Tohru; Ishibashi, Keiichiro; Ohsawa, Tomonori; Okada, Norimichi; Kumamoto, Kensuke; Haga, Norihiro

    2011-01-01

    Minilaparotomy has been reported to be a minimally invasive alternative to laparoscopically assisted surgery. We retrospectively evaluated the usefulness of minilaparotomy for the resection of transverse colon cancer, which has generally been considered difficult to resect laparoscopically. Patients for whom curative resection was attempted for transverse colon cancer (n = 21) or sigmoid colon cancer (n = 81) via minilaparotomy (skin incision, transverse colon cancer as well as those with sigmoid colon cancer.

  20. Locally advanced pancreatic adenocarcinoma. Chemoradiotherapy, reevaluation and secondary resection

    International Nuclear Information System (INIS)

    Delpero, J.R.; Turrini, O.

    2006-01-01

    Induction chemoradiotherapy (CRT) may down-stage locally advanced pancreatic tumors but secondary resections are unfrequent. However some responders' patients may benefit of a RO resection. Patients and methods. We report 18 resections among 29 locally advanced pancreatic cancers; 15 patients were treated with neo-adjuvant 5-FU-cisplatin based (13) or taxotere based (2 patients) chemoradiotherapy (45 Gy), and 3 patients without histologically proven adenocarcinoma were resected without any preoperative treatment. Results. The morbidity rate was 28% and the mortality rate was 7%; one patient died after resection (5.5%) and one died after exploration (9%). The RO resection rate was 50%. The median survival for the resected patients was not reached and the actuarial survival at 3 years was 59%. Two specimens showed no residual tumor and the two patients were alive at 15 and 46 months without recurrence; one specimen showed less than 10% viable tumoral cells and the patient was alive at 36 months without recurrence. A mesenteric infarction was the cause of a late death at 3 years in a disease free patient (radiation induced injury of the superior mesenteric artery). The median survival of the 11 non-resected patients was 21 months and the actuarial survival at 2 years was 0%. When the number of the resected patients (18) was reported to the entire cohort of the patients with locally advanced pancreatic cancer treated during the same period in our institution, the secondary resectability rate was 9%. Conclusion. Preoperative chemoradiotherapy identifies poor surgical candidates through observation and may enhance the margin status of patients undergoing secondary resection for locally advanced tumors. However it remains difficult to evaluate the results in the literature because of the variations in the definitions of resectability. The best therapeutic strategy remains to be defined, because the majority of patients ultimately succumb with distant metastatic disease

  1. Management of postirradiation recurrent enterocutaneous fistula by muscle flaps

    Energy Technology Data Exchange (ETDEWEB)

    Lui, R.C.; Friedman, R.; Fleischer, A.

    1989-07-01

    Occasionally surgeons have to operate on patients who have had previous abdominal or pelvic operations and irradiations for malignancies. Bowel resection with primary anastomosis under these circumstances is fraught with major complications such as anastomotic breakdown with intra-abdominal sepsis or recurrent enterocutaneous fistula, which are refractory to conventional management. New techniques for using vascularized muscle flaps from a distant nonirradiated field to achieve safe repair of the bowel defects in three such instances are presented.

  2. Pseudomalignant myositis ossificans involving multiple masticatory muscles: Imaging evaluation

    International Nuclear Information System (INIS)

    Kamalapur, Muralidhar G; Patil, Pritam B; Joshi, Shyamsundar; Shastri, Dinesh

    2014-01-01

    Myositis ossificans is a rare cause of trismus. We present a case of pseudomalignant myositis ossificans involving medial pterygoid, lateral pterygoid, and temporalis muscles. Patient presented with gross limitation in mouth opening. There was no history of trauma. Computed tomography (CT) images revealed a bone density mass located in the region of medial and lateral pterygoid muscles on the right and temporalis muscle on the left. Magnetic resonance imaging (MRI) showed similar findings. Radiological diagnosis was pseudomalignant myositis ossificans. The masses were resected and histopathologic examination confirmed the above diagnosis. This report describes the characteristic CT and MRI features. The unique feature of this case is the absence of history of trauma with involvement of multiple masticatory muscles, which, to the best of our knowledge, has not been reported before

  3. Carinal resection and reconstruction following inflammatory myofibroblastic tumor resection: A case report

    Directory of Open Access Journals (Sweden)

    Julia G. Lyon

    2016-02-01

    Full Text Available Inflammatory myofibroblastic tumors (IMT are rare tumors of the respiratory tract that most commonly occur in the lung and are rarely seen in the trachea. They present most often in young patients. We report on a case of an IMT of the carina in a seven year old girl, requiring carinal resection and reconstruction with a novel technique in pediatric airway surgery. Attempts at endoscopic excision of the carinal IMT were unsuccessful. An open approach for resection of the involved carina, distal trachea, and proximal mainstem bronchi was performed via sternotomy and cardiopulmonary bypass. The resulting triangular defect in the trachea and bronchi was reconstructed with anastomosis of the proximal trachea and left mainstem bronchus using a rotational flap of the right lateral mainstem bronchial wall. The remaining right mainstem bronchus was anastomosed, end to side, to the intact trachea proximal to the primary anastomosis. Bronchoscopy and MRI 22 months post resection and reconstruction revealed a healthy neo-carina and patent distal airway with no evidence of recurrent IMT. Pediatric patients with carinal inflammatory myofibroblastic tumors can be successfully managed with open resection and reconstruction of the airway.

  4. Laparoscopic liver resection: wedge resections to living donor hepatectomy, are we heading in the right direction?

    Science.gov (United States)

    Cherian, P Thomas; Mishra, Ashish Kumar; Kumar, Palaniappen; Sachan, Vijayant Kumar; Bharathan, Anand; Srikanth, Gadiyaram; Senadhipan, Baiju; Rela, Mohamad S

    2014-10-07

    Despite inception over 15 years ago and over 3000 completed procedures, laparoscopic liver resection has remained mainly in the domain of selected centers and enthusiasts. Requirement of extensive open liver resection (OLR) experience, in-depth understanding of anatomy and considerable laparoscopic technical expertise may have delayed wide application. However healthy scepticism of its actual benefits and presence of a potential publication bias; concern about its safety and technical learning curve, are probably equally responsible. Given that a large proportion of our work, at least in transplantation is still OLR, we have attempted to provide an entirely unbiased, mature opinion of its pros and cons in the current invited review. We have divided this review into two sections as we believe they merit separate attention on technical and ethical grounds. The first part deals with laparoscopic liver resection (LLR) in patients who present with benign or malignant liver pathology, wherein we have discussed its overall outcomes; its feasibility based on type of pathology and type of resection and included a small section on application of LLR in special scenarios like cirrhosis. The second part deals with the laparoscopic living donor hepatectomy (LDH) experience to date, including its potential impact on transplantation in general. Donor safety, graft outcomes after LDH and criterion to select ideal donors for LLR are discussed. Within each section we have provided practical points to improve safety in LLR and attempted to reach reasonable recommendations on the utilization of LLR for units that wish to develop such a service.

  5. The value of liver resection for focal nodular hyperplasia: resection yes or no?

    Science.gov (United States)

    Hau, Hans Michael; Atanasov, Georgi; Tautenhahn, Hans-Michael; Ascherl, Rudolf; Wiltberger, Georg; Schoenberg, Markus Bo; Morgül, Mehmet Haluk; Uhlmann, Dirk; Moche, Michael; Fuchs, Jochen; Schmelzle, Moritz; Bartels, Michael

    2015-10-22

    Focal nodular hyperplasia (FNH) are benign lesions in the liver. Although liver resection is generally not indicated in these patients, rare indications for surgical approaches indeed exist. We here report on our single-center experience with patients undergoing liver resection for FNH, focussing on preoperative diagnostic algorithms and quality of life (QoL) after surgery. Medical records of 100 consecutive patients undergoing liver resection for FNH between 1992 and 2012 were retrospectively analyzed with regard to diagnostic pathways and indications for surgery. Quality of life (QoL) before and after surgery was evaluated using validated assessment tools. Student's t test, one-way ANOVA, χ (2), and binary logistic regression analyses such as Wilcoxon-Mann-Whitney test were used, as indicated. A combination of at least two preoperative diagnostic imaging approaches was applied in 99 cases, of which 70 patients were subjected to further imaging or tumor biopsy. In most patients, there was more than one indication for liver resection, including tumor-associated symptoms with abdominal discomfort (n = 46, 40.7 %), balance of risk for malignancy/history of cancer (n = 54, 47.8 %/n = 18; 33.3 %), tumor enlargement/jaundice of vascular and biliary structures (n = 13, 11.5 %), such as incidental findings during elective operation (n = 1, 0.9 %). Postoperative morbidity was 19 %, with serious complications (>grade 2, Clavien-Dindo classification) being evident in 8 %. Perioperative mortality was 0 %. Liver resection was associated with a significant overall improvement in general health (very good-excellent: preoperatively 47.4 % vs. postoperatively 68.1 %; p = 0.015). Liver resection remains a valuable therapeutic option in the treatment of either symptomatic FNH or if malignancy cannot finally be ruled out. If clinically indicated, liver resection for FNH represents a safe approach and may lead to significant improvements of QoL especially in

  6. Laparoscopic liver resection for malignancy: a review of the literature.

    Science.gov (United States)

    Alkhalili, Eyas; Berber, Eren

    2014-10-07

    To review the published literature about laparoscopic liver resection for malignancy. A PubMed search was performed for original published studies until June 2013 and original series containing at least 30 patients were reviewed. All forms of hepatic resections have been described ranging from simple wedge resections to extended right or left hepatectomies. The usual approach is pure laparoscopic, but hand-assisted, as well as robotic approaches have been described. Most studies showed comparable results to open resection in terms of operative blood loss, postoperative morbidity and mortality. Many of them showed decreased postoperative pain, shorter hospital stays, and even lower costs. Oncological results including resection margin status and long-term survival were not inferior to open resection. In the hands of experienced surgeons, laparoscopic liver resection for malignant lesions is safe and offers some short-term advantages over open resection. Oncologically, similar survival rates have been observed in patients treated with the laparoscopic approach when compared to their open resection counterparts.

  7. Laparoscopic liver resection assisted by the laparoscopic Habib Sealer.

    Science.gov (United States)

    Jiao, Long R; Ayav, Ahmet; Navarra, Giuseppe; Sommerville, Craig; Pai, Madhava; Damrah, Osama; Khorsandi, Shrin; Habib, Nagy A

    2008-11-01

    Radiofrequency has been used as a tool for liver resection since 2002. A new laparoscopic device is reported in this article that assists liver resection laparoscopically. From October 2006 to the present, patients suitable for liver resection were assessed carefully for laparoscopic resection with the laparoscopic Habib Sealer (LHS). Detailed data of patients resected laparoscopically with this device were collected prospectively and analyzed. In all, 28 patients underwent attempted laparoscopic liver resection. Four cases had to be converted to an open approach because of extensive adhesions from previous colonic operations. Twenty-four patients completed the procedure comprising tumorectomy (n = 7), multiple tumoretcomies (n = 5), segmentectomy (n = 3), and bisegmentectomies (n = 9). Vascular clamping of portal triads was not used. The mean resection time was 60 +/- 23 min (mean +/- SD), and blood loss was 48 +/- 54 mL. None of the patients received any transfusion of blood or blood products perioperatively or postoperatively. Postoperatively, 1 patient developed severe exacerbation of asthma that required steroid therapy, and 1 other patient had a transient episode of liver failure that required supportive care. The mean duration of hospital stay was 5.6 +/- 2 days (mean +/- SD). At a short-term follow up, no recurrence was detected in patients with liver cancer. Laparoscopic liver resection can be performed safely with this new laparoscopic liver resection device with a significantly low risk of intraoperative bleeding or postoperative complications.

  8. Effects of muscle composition and architecture on specific strength in obese older women.

    Science.gov (United States)

    Rastelli, F; Capodaglio, P; Orgiu, S; Santovito, C; Caramenti, M; Cadioli, M; Falini, A; Rizzo, G; Lafortuna, C L

    2015-10-01

    What is the central question of this study? Do obesity-specific factors affect skeletal muscle performance in older individuals? What is the main finding and its importance? Older obese women have a larger quadriceps femoris size but develop lower tension per unit of skeletal muscle than their normal-weight counterparts. Muscle impairment and excess body mass are very common among older people. Given that the effect of obesity on strength production has scarcely been studied in older individuals, we analysed functional and structural characteristics of quadriceps femoris (QF) in obese (OB) and normal-weight (NW) older women with comparable habitual physical activity. In five OB (body mass index 36.8 ± 1.9 kg m(-2), age 72.4 ± 2.3 years) and six NW well-functioning older women (body mass index 24.3 ± 1.8 kg m(-2), age 72.7 ± 1.9 years), peak knee-extension torque (KET) was measured in isometric (90 deg knee flexion) and isokinetic conditions (240, 180, 120 and 60 deg s(-1)). Mid-thigh QF cross-sectional area (CSA) and muscle tissue fat content (MF%) were determined with magnetic resonance imaging (Dixon sequence). Muscle fascicle length and pennation angle (PA) were assessed with ultrasonography for each muscle belly of the QF (vastus lateralis, vastus intermedius, rectus femoris and vastus intermedius). Despite similar values of KET, CSA was 17.0% larger in OB than in NW women (P Muscle composition and architecture seem to be important determinants of KET/CSA in elderly women. In fact, owing to the effect of obesity overload, OB women have a larger QF size than NW women, but unfavourable muscle composition and architecture. The higher MF% and steeper PA observed in OB women are associated with reduced levels of muscle specific strength. © 2015 The Authors. Experimental Physiology © 2015 The Physiological Society.

  9. Preoperative overnight parenteral nutrition (TPN) improves skeletal muscle protein metabolism indicated by microarray algorithm analyses in a randomized trial.

    Science.gov (United States)

    Iresjö, Britt-Marie; Engström, Cecilia; Lundholm, Kent

    2016-06-01

    Loss of muscle mass is associated with increased risk of morbidity and mortality in hospitalized patients. Uncertainties of treatment efficiency by short-term artificial nutrition remain, specifically improvement of protein balance in skeletal muscles. In this study, algorithmic microarray analysis was applied to map cellular changes related to muscle protein metabolism in human skeletal muscle tissue during provision of overnight preoperative total parenteral nutrition (TPN). Twenty-two patients (11/group) scheduled for upper GI surgery due to malignant or benign disease received a continuous peripheral all-in-one TPN infusion (30 kcal/kg/day, 0.16 gN/kg/day) or saline infusion for 12 h prior operation. Biopsies from the rectus abdominis muscle were taken at the start of operation for isolation of muscle RNA RNA expression microarray analyses were performed with Agilent Sureprint G3, 8 × 60K arrays using one-color labeling. 447 mRNAs were differently expressed between study and control patients (P nutrition; particularly anabolic signaling S6K1 (P parenteral nutrition is effective to promote muscle protein metabolism. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  10. Enhanced recovery after surgery in gastric resections.

    Science.gov (United States)

    Bruna Esteban, Marcos; Vorwald, Peter; Ortega Lucea, Sonia; Ramírez Rodríguez, Jose Manuel

    2017-02-01

    Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery. According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery. The measures to be applied are divided in a preoperative, perioperative and postoperative stage. This document provides recommendations concerning the appropriate information, limited fasting and administration of carbohydrate drinks 2hours before surgery, specialized anesthetic strategies, minimal invasive surgery, no routine use of drainages and tubes, mobilization and early oral tolerance during the immediate postoperative period, as well as criteria for discharge. The application of a protocol of enhanced recovery after surgery in resective gastric surgery can improve and accelerate the functional recovery of our patients, requiring an appropriate multidisciplinary coordination, the evaluation of obtained results with the application of these measures and the investigation of controversial topics about which we currently have limited evidence. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Multimodal treatment for resectable esophageal cancer

    International Nuclear Information System (INIS)

    Miyata, Hiroshi; Yamasaki, Makoto; Kurokawa, Yukinori; Takiguchi, Shuji; Nakajima, Kiyokazu; Fujiwara, Yoshiyuki; Mori, Masaki; Doki, Yuichiro

    2011-01-01

    Surgical resection has been traditionally the mainstay of treatment for localized esophageal cancers. However, survival after surgery alone for advanced esophageal cancer is not satisfactory. In Japan, the development of multimodal therapy for esophageal cancers has centered mainly on systemic chemotherapy plus surgery to control distant metastasis. Based on the results of the recent Japan Clinical Oncology Group (JCOG) 9907 study, preoperative chemotherapy (consisting of 5-fluorouracil (FU) and cisplatin) followed by surgery has emerged as the standard treatment. In Western countries, where chemoradiotherapy followed by surgery has been mainly explored for patients with resectable esophageal cancers, two large controlled trials that evaluated the effectiveness of preoperative chemotherapy reported conflicting results. However, a recent meta-analysis reported significant survival benefits for preoperative chemotherapy in patients with adenocarcinoma of the esophagus. We need to find new effective preoperative chemotherapeutic regimens, including molecular target agents, with response rates higher than that of the conventional chemotherapy of 5-FU and cisplatin. However, we also must compare the survival benefits of preoperative chemotherapy with preoperative chemoradiotherapy. (author)

  12. Cheledochal cyst resection and laparoscopic hepaticoduodenostomy

    Directory of Open Access Journals (Sweden)

    Jiménez Urueta Pedro Salvador

    2014-07-01

    Full Text Available Background. Choledochal cyst is a rare abnormality. Its esti- mated incidence is of 1:100,000 to 150,000 live births. Todani et al. in 1981 reported the main objection for performing a simpler procedure, i.e., hepaticoduodenostomy, has been the risk of an “ascending cholangitis”. This hazard, however, seems to be exaggerated. Methods: A laparoscopic procedure was performed in 8 consecutive patients with choledochal cyst between January 2010 and Septem- ber 2012; 6 females and 2 males mean age was 8 years. Results. Abdominal pain was the main symptom in everyone, jaundice in 1 patient and a palpable mass in 3 patients. Lapa- roscopic surgical treatment was complete resection of the cyst with cholecystectomy and hepaticoduodenostomy laparoscopy in every patient. Discussion and conclusion. A laparoscopic approach to chole- dochal cyst resection and hepaticoduodenostomy is feasible and safe. The hepaticoduodenal anastomosis may confer additional benefits over hepaticojejunostomy in the setting of a laparoscopic approach. The creation of a single anastomosis can decrease operative time and anesthetic exposure.

  13. Distal muscle activity alterations during the stance phase of gait in restless leg syndrome (RLS) patients.

    Science.gov (United States)

    Dafkin, Chloe; Green, Andrew; Olivier, Benita; McKinon, Warrick; Kerr, Samantha

    2018-05-01

    To assess if there is a circadian variation in electromyographical (EMG) muscle activity during gait in restless legs syndrome (RLS) patients and healthy control participants. Gait assessment was done in 14 RLS patients and 13 healthy control participants in the evening (PM) and the morning (AM). Muscle activity was recorded bilaterally from the tibialis anterior (TA), lateral gastrocnemius (GL), rectus femoris (RF) and biceps femoris (BF) muscles. A circadian variation during the stance phase in only TA (PM > AM, p  Controls, p < 0.05) during early stance and decreased GL activity (RLS < Controls, p < 0.01) during terminal stance in comparison to control participants in the evening. No other significant differences were noted between RLS patients and control participants. Activation of GL during the swing phase was noted in 79% of RLS patients and in 23% of control participants in the morning compared to 71% and 38% in the evening, respectively. EMG muscle activity shows no circadian variation in RLS patients. Evening differences in gait muscle activation patterns between RLS patients and control participants are evident. These results extend our knowledge about alterations in spinal processing during gait in RLS. A possible explanation for these findings is central pattern generator sensitization caused by increased sensitivity in cutaneous afferents in RLS patients. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Distribution of skeletal muscle involvement in autosomal recessive distal muscular dystrophy

    International Nuclear Information System (INIS)

    Mizusawa, Hidehiro; Nakanishi, Takao; Kobayashi, Fumie.

    1987-01-01

    Distribution of skeletal muscle involvement in 5 cases with autosomal recessive distal muscular dystrophy was studied clinically and by computed tomography (CT). Manual muscle test showed muscle involvement with a predilection for flexors in the lower leg and adductors in the thigh. Flexion and extension of the thigh and the lower leg was impaired to similar degree. In progressed cases, neck flexors and trunk muscles were also affected mildly. CT disclosed more clearly the preferential involvement of flexors in the lower leg, and involvement of both hamstrings · adductors group and extensors group of the thigh to similar degree. However, m. popliteus was curiously well preserved. In addition, there was a stage showing high density and hypertrophy of m. sartorius, m. gracilis, m. adductor, m. biceps femoris, m. semimenbranosus, m. semitendinosus or m. rectus femoris, which in thought to be compensatory hypertrophy. M. gluteus minimus in the pelvic girdle and m. dorsi proprii in the trunk were also liable to be affected. The CT findings are regarded as characteristic features noted clearly before muscle weakness and atrophy become apparent clinically. CT is very useful for distinguishing distal muscular dystrophy from rimmed vacuolar distal myopathy in which m. quadriceps femoris and flexors of the lower leg are usually well preserved without compensatory hypertrophy on CT. (author)

  15. Evaluating abdominal core muscle fatigue: Assessment of the validity and reliability of the prone bridging test.

    Science.gov (United States)

    De Blaiser, C; De Ridder, R; Willems, T; Danneels, L; Vanden Bossche, L; Palmans, T; Roosen, P

    2018-02-01

    The aims of this study were to research the amplitude and median frequency characteristics of selected abdominal, back, and hip muscles of healthy subjects during a prone bridging endurance test, based on surface electromyography (sEMG), (a) to determine if the prone bridging test is a valid field test to measure abdominal muscle fatigue, and (b) to evaluate if the current method of administrating the prone bridging test is reliable. Thirty healthy subjects participated in this experiment. The sEMG activity of seven abdominal, back, and hip muscles was bilaterally measured. Normalized median frequencies were computed from the EMG power spectra. The prone bridging tests were repeated on separate days to evaluate inter and intratester reliability. Significant differences in normalized median frequency slope (NMF slope ) values between several abdominal, back, and hip muscles could be demonstrated. Moderate-to-high correlation coefficients were shown between NMF slope values and endurance time. Multiple backward linear regression revealed that the test endurance time could only be significantly predicted by the NMF slope of the rectus abdominis. Statistical analysis showed excellent reliability (ICC=0.87-0.89). The findings of this study support the validity and reliability of the prone bridging test for evaluating abdominal muscle fatigue. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Inter- and intramuscular differences in training-induced hypertrophy of the quadriceps femoris: association with muscle activation during the first training session.

    Science.gov (United States)

    Wakahara, Taku; Ema, Ryoichi; Miyamoto, Naokazu; Kawakami, Yasuo

    2017-07-01

    The purpose of this study was to examine whether inter- and intramuscular differences in hypertrophy induced by resistance training correspond to differences in muscle activation during the first training session. Eleven young men completed 12 weeks of training intervention for knee extension. Before and after the intervention, T1-weighted magnetic resonance (MR) images were recorded to determine the volume and anatomical cross-sectional area (CSA) along the length of the individual muscles of the quadriceps femoris. The T2-weighted MR images were also acquired before and immediately after the first training session. The T2 was calculated for each pixel within the quadriceps femoris, from which the muscle activation was evaluated as %activated volume and area. The results showed that the %activated volume after the first training session was significantly higher in the vastus intermedius than the vastus medialis. However, the relative change in muscle volume after the training intervention was significantly greater in the rectus femoris than the vasti muscles (vastus lateralis, intermedius and medialis). Within the rectus femoris, both the %activated area and relative increase in CSA were significantly greater in the distal region than the proximal region. In contrast, the %activated area and relative increase in CSA of the vasti were nearly uniform along each muscle. These results suggest that the muscle activation during the first training session is associated with the intramuscular difference in hypertrophy induced by training intervention, but not with the intermuscular difference. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  17. The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study.

    Science.gov (United States)

    Park, Byoung-Sun; Noh, Ji-Woong; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-11-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study's participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject's comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients' pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters.

  18. The influence of different footwear on 3-D kinematics and muscle activation during the barbell back squat in males.

    Science.gov (United States)

    Sinclair, Jonathan; McCarthy, Derek; Bentley, Ian; Hurst, Howard Thomas; Atkins, Stephen

    2015-01-01

    The barbell back squat is commonly used by athletes participating in resistance training. The barbell squat is typically performed using standard athletic shoes, or specially designed weightlifting footwear, although there are now a large number of athletes who prefer to squat barefoot or in barefoot-inspired footwear. This study aimed to determine how these footwear influence 3-D kinematics and muscle activation potentials during the barbell back squat. Fourteen experienced male participants completed squats at 70% 1 rep max in each footwear condition. 3-D kinematics from the torso, hip, knee and ankle were measured using an eight-camera motion analysis system. In addition, electromyographical (EMG) measurements were obtained from the rectus femoris, tibialis anterior, gastrocnemius, erector spinae and biceps femoris muscles. EMG parameters and joint kinematics were compared between footwear using repeated-measures analyses of variance. Participants were also asked to subjectively rate which footwear they preferred when performing their squat lifts; this was examined a chi-squared test. The kinematic analysis indicated that, in comparison to barefoot the running shoe was associated with increased squat depth, knee flexion and rectus femoris activation. The chi-squared test was significant and showed that participants preferred to squat barefoot. This study supports anecdotal evidence of athletes who prefer to train barefoot or in barefoot-inspired footwear although no biomechanical evidence was found to support this notion.

  19. Nineth Rib Syndrome after 10(th) Rib Resection.

    Science.gov (United States)

    Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon; Yim, Kyoung Hoon

    2016-07-01

    The 12(th) rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the 10(th) rib was not felt, and an image of the rib-cage confirmed that the left 10(th) rib was severed. When applying pressure from the legs to the 9(th) rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with 9(th) rib syndrome, and ultrasound-guided 9(th) and 10(th) intercostal nerve blocks were performed around the tips of the severed 10(th) rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the 9(th) rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left 10(th) rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining 10(th) rib to impinge on the 9(th) intercostal nerves, causing pain.

  20. Efectos de la vibración sobre la actividad del rectus abdominis y sobre la transmisión de aceleraciones durante la realización de un puente frontal. (Effects of whole body vibration on rectus abdominis activity and transmission of accelerations during a front bridge exercise.

    Directory of Open Access Journals (Sweden)

    Francisco José Vera-García

    2012-04-01

    Full Text Available Resumen Durante las dos últimas décadas se ha incrementado notablemente la utilización de la vibración como medio complementario de ejercicio físico. La literatura científica muestra distintos efectos positivos, aunque la mayor parte de ensayos se han centrado en el análisis del ejercicio de squat. El objetivo del presente estudio fue analizar la actividad muscular del rectus abdominis y la transmisión de la vibración en el cuerpo humano durante la realización de un puente frontal sobre una plataforma vibratoria oscilante vibrando a diferentes frecuencias (5, 16, 20 Hz y a una amplitud constante (3 mm. Las aceleraciones máximas en la cabeza (ejes X, Y, Z y la actividad electromiográfica media del rectus abdominis fueron determinadas en 31 sujetos sanos por medio de un acelerómetro triaxial y electromiografía de superficie. Para cada eje se calculó un coeficiente de amortiguación restando la aceleración máxima registrada en la cabeza a la aceleración máxima registrada sobre la plataforma. La actividad electromiográfica del rectus abdominis y los coeficientes de amortiguación en los ejes X y Z aumentaron significativamente con cada incremento en la frecuencia de vibración de la plataforma (p AbstractWhole-body vibration exercise have been widely used during the last two decades, with most scientific publications reporting various positive effects. Most commonly, squat exercises have been studied. Instead, this study explored the rectus abdominis activity and the transmission of sinusoidal vibration to the human body during the performance of front bridges on a oscillating vibration platform at different frequencies (5, 16, 20 Hz with constant amplitude (3 mm. Maximal vibration-induced accelerations at the head (axis X, Y, Z and mean electromyographic activity were assessed in thirty-one healthy subjects using a skin-mounted triaxial accelerometer and surface electromyography. A damping coefficient was calculated for each

  1. Duodenal endoscopic full-thickness resection (with video).

    Science.gov (United States)

    Schmidt, Arthur; Meier, Benjamin; Cahyadi, Oscar; Caca, Karel

    2015-10-01

    Endoscopic resection of duodenal non-lifting adenomas and subepithelial tumors is challenging and harbors a significant risk of adverse events. We report on a novel technique for duodenal endoscopic full-thickness resection (EFTR) by using an over-the-scope device. Data of 4 consecutive patients who underwent duodenal EFTR were analyzed retrospectively. Main outcome measures were technical success, R0 resection, histologic confirmation of full-thickness resection, and adverse events. Resections were done with a novel, over-the-scope device (full-thickness resection device, FTRD). Four patients (median age 60 years) with non-lifting adenomas (2 patients) or subepithelial tumors (2 patients) underwent EFTR in the duodenum. All lesions could be resected successfully. Mean procedure time was 67.5 minutes (range 50-85 minutes). Minor bleeding was observed in 2 cases; blood transfusions were not required. There was no immediate or delayed perforation. Mean diameter of the resection specimen was 28.3 mm (range 22-40 mm). Histology confirmed complete (R0) full-thickness resection in 3 of 4 cases. To date, 2-month endoscopic follow-up has been obtained in 3 patients. In all cases, the over-the-scope clip was still in place and could be removed without adverse events; recurrences were not observed. EFTR in the duodenum with the FTRD is a promising technique that has the potential to spare surgical resections. Modifications of the device should be made to facilitate introduction by mouth. Prospective studies are needed to further evaluate efficacy and safety for duodenal resections. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  2. Effects of replacing free weights with elastic band resistance in squats on trunk muscle activation.

    Science.gov (United States)

    Saeterbakken, Atle H; Andersen, Vidar; Kolnes, Maria K; Fimland, Marius S

    2014-11-01

    The purpose of this study was to assess the effects of adding elastic bands to free-weight squats on the neuromuscular activation of core muscles. Twenty-five resistance trained women with 4.6 ± 2.1 years of resistance training experience participated in the study. In randomized order, the participants performed 6 repetition maximum in free-weight squats, with and without elastic bands (i.e., matched relative intensity between exercises). During free-weight squats with elastic bands, some of the free weights were replaced with 2 elastic bands attached to the lowest part of the squat rack. Surface electromyography (EMG) activity was measured from the erector spinae, external oblique, and rectus abdominis, whereas a linear encoder measured the vertical displacement. The EMG activities were compared between the 2 lifting modalities for the whole repetition and separately for the eccentric, concentric, and upper and lower eccentric and concentric phases. In the upper (greatest stretch of the elastic band), middle, and lower positions in squats with elastic bands, the resistance values were approximately 117, 105, and 93% of the free weight-only trial. Similar EMG activities were observed for the 2 lifting modalities for the erector spinae (p = 0.112-0.782), external oblique (p = 0.225-0.977), and rectus abdominis (p = 0.315-0.729) in all analyzed phases. In conclusion, there were no effects on the muscle activity of trunk muscles of substituting some resistance from free weights with elastic bands in the free-weight squat.

  3. Changes in hip joint muscle-tendon lengths with mode of locomotion.

    Science.gov (United States)

    Riley, Patrick O; Franz, Jason; Dicharry, Jay; Kerrigan, D Casey

    2010-02-01

    We have reported that peak hip extension is nearly identical in walking and running, suggesting that anatomical constraints, such as flexor muscle tightness may limit the range of hip extension. To obtain a more mechanistic insight into mobility at the hip and pelvis we examined the lengths of the muscle-tendons units crossing the hip joint. Data defining the three-dimensional kinematics of 26 healthy runners at self-selected walking and running speeds were obtained. These data were used to scale and drive musculoskeletal models using OpenSIM. Muscle-tendon unit (MTU) lengths were calculated for the trailing limb illiacus, rectus femoris, gluteus maximus, and biceps femoris long head and the advancing limb biceps femoris and gluteus maximus. The magnitude and timing of MTU length peaks were each compared between walking and running. The peak length of the right (trailing limb) illiacus MTU, a pure hip flexor, was nearly identical between walking and running, while the maximum length of the rectus femoris MTU, a hip flexor and knee extensor, increased during running. The maximum length of the left (leading limb) biceps femoris was also unchanged between walking and running. Further, the timing of peak illiacus MTU length and peak contralateral biceps femoris MTU length occurred essentially simultaneously during running, at a time during gait when the hamstrings are most vulnerable to stretch injury. This latter finding suggests exploring the role for hip flexor stretching in combination with hamstring stretching to treat and/or prevent running related hamstring injury. Copyright 2009 Elsevier B.V. All rights reserved.

  4. Laparoscopic versus open resection for sigmoid diverticulitis.

    Science.gov (United States)

    Abraha, Iosief; Binda, Gian A; Montedori, Alessandro; Arezzo, Alberto; Cirocchi, Roberto

    2017-11-25

    Diverticular disease is a common condition in Western industrialised countries. Most individuals remain asymptomatic throughout life; however, 25% experience acute diverticulitis. The standard treatment for acute diverticulitis is open surgery. Laparoscopic surgery - a minimal-access procedure - offers an alternative approach to open surgery, as it is characterised by reduced operative stress that may translate into shorter hospitalisation and more rapid recovery, as well as improved quality of life. To evaluate the effectiveness of laparoscopic surgical resection compared with open surgical resection for individuals with acute sigmoid diverticulitis. We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 2) in the Cochrane Library; Ovid MEDLINE (1946 to 23 February 2017); Ovid Embase (1974 to 23 February 2017); clinicaltrials.gov (February 2017); and the World Health Organization (WHO) International Clinical Trials Registry (February 2017). We reviewed the bibliographies of identified trials to search for additional studies. We included randomised controlled trials comparing elective or emergency laparoscopic sigmoid resection versus open surgical resection for acute sigmoid diverticulitis. Two review authors independently selected studies, assessed the domains of risk of bias from each included trial, and extracted data. For dichotomous outcomes, we calculated risk ratios (RRs) with 95% confidence intervals (CIs). For continuous outcomes, we planned to calculate mean differences (MDs) with 95% CIs for outcomes such as hospital stay, and standardised mean differences (SMDs) with 95% CIs for quality of life and global rating scales, if researchers used different scales. Three trials with 392 participants met the inclusion criteria. Studies were conducted in three European countries (Switzerland, Netherlands, and Germany). The median age of participants ranged from 62 to 66 years; 53% to 64% were

  5. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    Science.gov (United States)

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  6. Change in skeletal muscle stiffness after running competition is dependent on both running distance and recovery time: a pilot study

    Directory of Open Access Journals (Sweden)

    Seyedali Sadeghi

    2018-03-01

    Full Text Available Long-distance running competitions impose a large amount of mechanical loading and strain leading to muscle edema and delayed onset muscle soreness (DOMS. Damage to various muscle fibers, metabolic impairments and fatigue have been linked to explain how DOMS impairs muscle function. Disruptions of muscle fiber during DOMS exacerbated by exercise have been shown to change muscle mechanical properties. The objective of this study is to quantify changes in mechanical properties of different muscles in the thigh and lower leg as function of running distance and time after competition. A custom implementation of Focused Comb-Push Ultrasound Shear Elastography (F-CUSE method was used to evaluate shear modulus in runners before and after a race. Twenty-two healthy individuals (age: 23 ± 5 years were recruited using convenience sampling and split into three race categories: short distance (nine subjects, 3–5 miles, middle distance (10 subjects, 10–13 miles, and long distance (three subjects, 26+ miles. Shear Wave Elastography (SWE measurements were taken on both legs of each subject on the rectus femoris (RF, vastus lateralis (VL, vastus medialis (VM, soleus, lateral gastrocnemius (LG, medial gastrocnemius (MG, biceps femoris (BF and semitendinosus (ST muscles. For statistical analyses, a linear mixed model was used, with recovery time and running distance as fixed variables, while shear modulus was used as the dependent variable. Recovery time had a significant effect on the soleus (p = 0.05, while running distance had considerable effect on the biceps femoris (p = 0.02, vastus lateralis (p < 0.01 and semitendinosus muscles (p = 0.02. Sixty-seven percent of muscles exhibited a decreasing stiffness trend from before competition to immediately after competition. The preliminary results suggest that SWE could potentially be used to quantify changes of muscle mechanical properties as a way for measuring recovery procedures for runners.

  7. Comparative analysis of laparoscopic low rectal resections

    Directory of Open Access Journals (Sweden)

    I. L. Chernikovsky

    2015-01-01

    Full Text Available Objective: to study the immediate results of laparoscopic intersphincteric resection (ISR and ultralow anterior resection (ULAR of the rectum.Subjects and methods. The results of surgical treatment in 42 patients operated on in the Saint Petersburg Clinical Research-Practical Center for Specialized Medical (Oncology Cares in March 2014 to January 2015 are given. The inclusion criteria were the lower edge of cT1–3N0 adenocarcinoma 2-5 cm above the dentate line and no signs of invasion into the sphincter and levators. All the patients were divided into 2 groups: 1 24 patients who had undergone laparoscopic ISR; 2 18 patients who had laparoscopic ULAR. Both groups were matched for gender, age, body mass index, and CR-POSSUM predicted mortality scores. Thirty-two patients received neoadjuvant chemoradiotherapy. Results. The mean duration of operations did not differ significantly in the groups: 206 ± 46 and 216 ± 24 min (р = 0.72. The differences in the mean volume of blood loss were also insignificant: 85 and 113 ml (р = 0.93. Circular and distal resection margins were intact in all the cases. In 18 (75 % patients in Group 1 and in 14 (77.8 % patients in Group 2, the quality of total mesorectumectomy (TME was rated as grade 3 according to the Quirk criteria (p = 0.83. In Group 1, complications requiring no reoperation occurred in 5 (20.8 % cases: anastomotic incompetence in 3 (12.5 % cases, anastomotic stricture with further bougienage in 1 (4.2 %, and urinary retention in 1 (4.2 %. In Group 2, postoperative coтplications were also observed in 5 (27.8 % cases: necrosis of the brought-out bowel in 2 (11.1 % patients and coloanal incompetence in 1 (5.6 % required reoperation; 2 (11.1 % patients underwent bougienage due to established anastomotic stricture. One month postoperatively, the Wexner constipation scoring system was used to rate the degree of encopresis: anal incontinence turned out to be significantly higher in Group 2 and amounted

  8. The incidence and location of diastasis rectus abdominis during the childbearing year and puerperium at the maternity hospital Ljubljana

    Directory of Open Access Journals (Sweden)

    Mateja Šerbec Medjimurec

    2018-06-01

    Full Text Available Background: The purpose of the research was to determine the prevalence and location of diastasis recti abdominis muscle (DRA during pregnancy and puerperium in women in the Ljubljana maternity hospital. Methods: The study sample included sixty randomly selected women; forty-five pregnant and postpartum women were recruited from the Ljubljana Maternity Hospital, and fifteen non-pregnant women from the larger Ljubljana area as a control group. All women were examined for the presence or absence of diastasis recti abdominis muscle along with the most and least likely location along the white lines. The measurements were performed by the finger-width method. Results: The findings indicate that the diastasis recti abdominis muscle increases with the progression of pregnancy. In the case of non-pregnant women, the diastasis is not present. The presence of DRA was first observed in the second trimester of pregnancy (9.5 % and was most common in the third trimester (52.4 %. After birth, the incidence decreased (38.1 %. The majority of diastasis recti abdominis cases were observed in the umbilical area (52.6 % in the third trimester. In the puerperium group three days after childbirth the diastasis below the umbilicus was most common (60.0 % and slightly less common above the umbilicus (53.8 %. Conclusion: Diastasis recti abdominis muscle during pregnancy and after childbirth is a common condition. It is therefore recommended that all women should be timely examined for the presence of DRA before and after birth along the linea alba to start timely and adequate physiotherapy treatment. Health professionals as well as sports teachers and coaches who work with pregnant and puerperium women should be educated/trained in the field of testing and treatment of diastasis recti abdominis muscle.

  9. A comparative analysis of the electrical activity of the abdominal muscles during traditional and Pilates-based exercises under two conditions

    Directory of Open Access Journals (Sweden)

    Mariana Felipe Silva

    2013-04-01

    Full Text Available The use of Pilates-based exercises for trunk strengthening has been reported in the literature. The objective of this study was to analyze and compare the electrical activity of the rectus abdominis and external oblique muscles during a traditional abdominal exercise program and an exercise program based on the Pilates method using a ball and an elastic band. The sample was composed of 10 healthy women, non-practitioners of Pilates, who performed the traditional abdominal exercise and roll-up with the ball and elastic band. The sign was normalized by the electromyographic peak of the dynamics activity and was adjusted for 2000 samples/s; the filter was set in a frequency band from 20 to 450 Hz. In the comparison between exercises, the external oblique muscle in the concentric phase had a higher recruitment in the roll-up with the ball (P =0.042. In the comparison between muscles in each exercise, the rectus abdominis showed a higher activation in the concentric phase (P = 0.009 and in the eccentric phase (P = 0.05 of the traditional abdominal exercise. Activation percentages ranged from 15% to 22%. The traditional abdominal exercise had the largest activation percentage.

  10. Liver resection for non-cirrhotic hepatocellular carcinoma in south ...

    African Journals Online (AJOL)

    Background. We describe the clinicopathologic features and outcome of South African patients who have undergone hepatic resection for hepatocellular carcinoma (HCC) arising in a non-cirrhotic liver. Methods. We utilised the prospective liver resection database in the Surgical Gastroenterology Unit at Groote Schuur ...

  11. Results of postoperative radiotherapy for resectable hilar cholangiocarcinoma

    NARCIS (Netherlands)

    Gerhards, Michael F.; van Gulik, Thomas M.; González González, Dioniso; Rauws, Erik A. J.; Gouma, Dirk J.

    2003-01-01

    The aim of this study was to assess the value of radiotherapy, and especially intraluminal brachytherapy, after resection of hilar cholangio-carcinoma by analyzing long-term complications and survival. Between 1983 and 1998, 112 patients underwent resection of a hilar cholangio-carcinoma. Of the 91

  12. Resection of pancreatic cancer in Europe and USA

    DEFF Research Database (Denmark)

    Huang, Lei; Jansen, Lina; Balavarca, Yesilda

    2018-01-01

    European population-based cancer registries and the US Surveillance, Epidemiology, and End Results Program database during 2003-2016 were analysed. Age-standardised resection rates for overall and stage I-II PaCs were computed. Associations between resection and demographic and clinical parameters were...

  13. Spontaneous regeneration after juvenile ossifying fibroma resection: a case report.

    Science.gov (United States)

    Espinosa, Sebastián A; Villanueva, Julio; Hampel, Hans; Reyes, Daniel

    2006-11-01

    A case of unusual bone regeneration after resection of a juvenile ossifying fibroma (JOF) is presented. Secondary mandibular reconstruction with autogenous grafts was delayed due to the rapid bone formation. To the best of our knowledge there are no reports of this unusual response following JOF resection.

  14. Endoscopic lesions in Crohn's disease early after ileocecal resection

    NARCIS (Netherlands)

    Tytgat, G. N.; Mulder, C. J.; Brummelkamp, W. H.

    1988-01-01

    Fifty patients with Crohn's disease were studied endoscopically 6 weeks to 6 months (median 9 weeks) after ileocecal or ileocolonic resection for evidence of non-resected abnormality. Only 8 of the 50 patients were endoscopically free of abnormalities. Microscopic examination of the surgical

  15. Comparison between open and arthroscopic procedure for lateral clavicle resection

    NARCIS (Netherlands)

    Duindam, N.; Kuiper, J.W.P.; Hoozemans, M.J.M.; Burger, B.J.

    2014-01-01

    Purpose: Arthroscopic lateral clavicle resection (LCR) is increasingly used, compared to an open approach, but literature does not clearly indicate which approach is preferable. The goal of this study was to compare function and pain between patients who underwent lateral clavicle resection using an

  16. Rapid rehabilitation in elderly patients after laparoscopic colonic resection

    DEFF Research Database (Denmark)

    Bardram, L.; Funch-Jensen, Peter; Kehlet, H.

    2000-01-01

    . Routine use of morphine and traditional tubes, drains and prolonged bladder catheterization was avoided. RESULTS: Laparoscopic resection was intended in 50 consecutive patients, of median age 81 years. The conversion rate to open resection was 22 per cent. In patients in whom the procedure was completed...

  17. Pancreatoduodenectomy with colon resection for cancer: A nationwide retrospective analysis

    NARCIS (Netherlands)

    Marsman, E. Madelief; de Rooij, Thijs; van Eijck, Casper H.; Boerma, Djamila; Bonsing, Bert A.; van Dam, Ronald M.; van Dieren, Susan; Erdmann, Joris I.; Gerhards, Michael F.; de Hingh, Ignace H.; Kazemier, Geert; Klaase, Joost; Molenaar, I. Quintus; Patijn, Gijs A.; Scheepers, Joris J.; Tanis, Pieter J.; Busch, Olivier R.; Besselink, Marc G.

    2016-01-01

    Microscopically radical (R0) resection of pancreatic, periampullary, or colon cancer may occasionally require a pancreatoduodenectomy with colon resection (PD-colon), but the benefits of this procedure have been disputed, and multicenter studies on morbidity and oncologic outcomes after PD-colon are

  18. Tracheal schwannoma: Completely resected with therapeutic bronchoscopic techniques

    Directory of Open Access Journals (Sweden)

    Barney Thomas Jesudason Isaac

    2015-01-01

    Full Text Available Tracheal schwannomas are rare benign tumors of the trachea. There are only a few reported cases in the literature. Surgeons have generally resected these tumors, whereas bronchoscopists have attempted to remove them bronchoscopically. We report a case of tracheal schwannoma which was completely resected using bronchoscopic techniques.

  19. Fluorescence Imaging/Agents in Tumor Resection.

    Science.gov (United States)

    Stummer, Walter; Suero Molina, Eric

    2017-10-01

    Intraoperative fluorescence imaging allows real-time identification of diseased tissue during surgery without being influenced by brain shift and surgery interruption. 5-Aminolevulinic acid, useful for malignant gliomas and other tumors, is the most broadly explored compound approved for fluorescence-guided resection. Intravenous fluorescein sodium has recently received attention, highlighting tumor tissue based on extravasation at the blood-brain barrier (defective in many brain tumors). Fluorescein in perfused brain, unselective extravasation in brain perturbed by surgery, and propagation with edema are concerns. Fluorescein is not approved but targeted fluorochromes with affinity to brain tumor cells, in development, may offer future advantages. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Determinants of survival after liver resection for metastatic colorectal carcinoma.

    Science.gov (United States)

    Parau, Angela; Todor, Nicolae; Vlad, Liviu

    2015-01-01

    Prognostic factors for survival after liver resection for metastatic colorectal cancer identified up to date are quite inconsistent with a great inter-study variability. In this study we aimed to identify predictors of outcome in our patient population. A series of 70 consecutive patients from the oncological hepatobiliary database, who had undergone curative hepatic surgical resection for hepatic metastases of colorectal origin, operated between 2006 and 2011, were identified. At 44.6 months (range 13.7-73), 30 of 70 patients (42.85%) were alive. Patient demographics, primary tumor and liver tumor factors, operative factors, pathologic findings, recurrence patterns, disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) were analyzed. Clinicopathologic variables were tested using univariate and multivariate analyses. The 3-year CSS after first hepatic resection was 54%. Median CSS survival after first hepatic resection was 40.2 months. Median CSS after second hepatic resection was 24.2 months. The 3-year DFS after first hepatic resection was 14%. Median disease free survival after first hepatic resection was 18 months. The 3-year DFS after second hepatic resection was 27% and median DFS after second hepatic resection 12 months. The 30-day mortality and morbidity rate after first hepatic resection was 5.71% and 12.78%, respectively. In univariate analysis CSS was significantly reduced for the following factors: age >53 years, advanced T stage of primary tumor, moderately- poorly differentiated tumor, positive and narrow resection margin, preoperative CEA level >30 ng/ml, DFS <18 months. Perioperative chemotherapy related to metastasectomy showed a trend in improving CSS (p=0.07). Perioperative chemotherapy improved DFS in a statistically significant way (p=0.03). Perioperative chemotherapy and achievement of resection margins beyond 1 mm were the major determinants of both CSS and DFS after first liver resection in multivariate

  1. Underwater colorectal EMR: remodeling endoscopic mucosal resection.

    Science.gov (United States)

    Curcio, Gabriele; Granata, Antonino; Ligresti, Dario; Tarantino, Ilaria; Barresi, Luca; Liotta, Rosa; Traina, Mario

    2015-05-01

    Underwater EMR (UEMR) has been reported as a new technique for the removal of large sessile colorectal polyps without need for submucosal injection. To evaluate (1) outcomes of UEMR, (2) whether UEMR can be easily performed by an endoscopist skilled in traditional EMR without specific dedicated training in UEMR, and (3) whether EUS is required before UEMR. Prospective, observational study. Single, tertiary-care referral center. Underwater EMR. Complete resection and adverse events. A total of 72 consecutive patients underwent UEMR of 81 sessile colorectal polyps. EUS was performed before UEMR in 9 cases (11.1%) with a suspicious mucosal/vascular pattern. The mean polyp size was 18.7 mm (range 10-50 mm); the mean UEMR time was 11.8 minutes. Fifty-five polyps (68%) were removed en bloc, and 26 (32%) were removed with a piecemeal technique. Histopathology consisted of tubular adenomas (25.9%), tubulovillous adenomas (5%), adenomas with high-grade dysplasia (42%), serrated polyps (4.9%), carcinoma in situ (13.6%), and hyperplastic polyps (8.6%). Surveillance colonoscopy was scheduled at 3 months. Complete resection was successful in all patients. No adverse events or recurrence was recorded in any of the patients. Limited follow-up; single-center, uncontrolled study. Interventional endoscopists skilled in conventional EMR performed UEMR without specific dedicated training. EUS may not be required for lesions with no invasive features on high-definition narrow-band imaging. UEMR appears to be an effective and safe alternative to traditional EMR and could eventually improve the way in which we can effectively and safely treat colorectal lesions. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  2. Radiotherapy after subtotally resected or recurrent ganglioglioma

    International Nuclear Information System (INIS)

    Liauw, Stanley L.; Byer, Jennifer E.; Yachnis, Anthony T.; Amdur, Robert J.; Mendenhall, William M.

    2007-01-01

    Purpose: Gangliogliomas can recur after subtotal resection (STR). The role of postoperative radiation therapy (RT) is undefined. Methods and Materials: Eight consecutive patients with low-grade gangliogliomas (n = 7) or anaplastic gangliogliomas (n = 1) were treated with RT between 1987 and 2004. Median age was 17 years. Five patients received adjuvant RT after STR at a median time of 6 weeks after surgery. Three patients received salvage RT at a median time of 17 months after surgery. The median dose of RT was 54 Gy. Control was defined as no progressive disease on serial imaging. Median follow-up was 8.8 years. Results: Of the 7 patients with low-grade gangliogliomas, 3 were controlled after RT and 4 recurred locally. Recurrences were controlled with further surgery (n = 2), chemotherapy (n 1), or re-irradiation (n = 1) (median follow-up, 9 years after salvage therapy). Patients who received adjuvant RT after STR of their low-grade gangliogliomas had an overall local control rate of 75%. All 3 patients who were treated with salvage RT had recurrences in the treated area alone (n 2) or in the treated area with leptomeningeal spread (n = 1). The patient with an anaplastic ganglioglioma was treated with adjuvant RT, and had recurrence in Radiation field after 4 months, then died 1 month later. Conclusions: Adjuvant RT may be indicated to treat select patients with subtotally resected gangliogliomas. Salvage RT for recurrence is probably less effective for long-term control; however, patients who recur may still be candidates for effective salvage therapies in the absence of malignant transformation

  3. Association of visceral fat area with abdominal skeletal muscle distribution in overweight Japanese adults.

    Science.gov (United States)

    Tanaka, Noriko I; Murakami, Haruka; Ohmori, Yumi; Aiba, Naomi; Morita, Akemi; Watanabe, Shaw; Miyachi, Motohiko

    2016-07-20

    Quantitative evaluation of visceral fat mass and skeletal muscle mass is important for health promotion. Recently, some studies suggested the existence of adipocyte-myocyte negative crosstalk. If so, abdominal skeletal muscles may easily and negatively affected not only by the age but also the visceral fat because age-related reduction in abdominal region is greater compared with limbs. We cross-sectionally examined the existence of quantitative associations between visceral fat area and abdominal skeletal muscle distribution in overweight people. A total of 230 Japanese males and females who aged 40-64 years and whose body mass index (BMI) was 28.0-44.8kg/m 2 participated in this study. The cross-sectional area (CSA) of the visceral fat, subcutaneous fat, and abdominal skeletal muscles, namely, the rectus abdominis, abdominal oblique, erector spinae, and iliopsoas muscles were measured by the computed tomography images. Stepwise regression analyses revealed the existence of sex difference in the relation between visceral fat CSA and other morphological variables. In males, BMI was a positive, and the iliopsoas muscle group CSA was a negative contributor of the visceral fat CSA. In females, both age and BMI were selected as positive contributors. These data suggested that the visceral fat CSA may negatively associated with iliopsoas muscle group CSA in males. In females, the visceral fat CSA was not significantly related to the distribution of the abdominal skeletal muscle groups. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  4. Determination of muscle fatigue index for strength training in patients with Duchenne dystrophy

    Directory of Open Access Journals (Sweden)

    Adriano Rodrigues Oliveira

    Full Text Available INTRODUCTION: Muscle weakness is the most prominent impairment in Duchenne muscular dystrophy (DMD and often involves the loss of functional ability as well as other limitations related to daily living. Thus, there is a need to maintain muscle strength in large muscle groups, such as the femoral quadriceps, which is responsible for diverse functional abilities. However, the load and duration of training for such rehabilitation has proven to be a great unknown, mainly due to the undesired appearance of muscle fatigue, which is a severe factor for the injury of muscle fibers. OBJECTIVES: The aim of the present study was to determine a fatigue index by means of surface electromyography (EMG for the parameterization of muscle strengthening physiotherapy training. METHODS: A cross-sectional study (case series was carried out involving four patients with DMD. Three pairs of surface electrodes were placed on the motor point of the Rectus femoris, Vastus lateralis and Vastus medialis of the dominant limb, maintaining the knee at 60º of flexion. The participants were instructed to perform the extension movement of this joint at four strength levels (100%, 80%, 60% and 40% of maximal voluntary isometric contraction. RESULTS: The slope of the linear regression line was used for the determination of the fatigue index, performed by Pearson's test on the median frequency of each strength level. CONCLUSION: Electromyographic measurements of the strength index for muscle training proved to be a simple accessible assessment method, as well as an extremely valuable tool, allowing the design of a muscle strength training program with an individualized load threshold.

  5. The ultrasound-guided nerve blocks of abdominal wall contributed to anesthetic management of cholecystectomy in a patient with Becker muscular dystrophy without using muscle relaxants.

    Science.gov (United States)

    Iwata, Masato; Kuzumoto, Naoya; Akasaki, Yuka; Morioka, Masayo; Nakayama, Kana; Matsuzawa, Nobuyoshi; Kimoto, Katsuhiro; Shimomura, Toshiyuki

    2017-01-01

    Becker muscular dystrophy (BMD) is a progressive neuromuscular disorder caused by mutations in the dystrophin gene. The sensitivity to non-depolarizing muscle relaxant in a patient with muscle dystrophy is reportedly higher than that in normal individuals, and the duration of the effect is known to be prolonged. In this report, we present the case of a 58-year-old man with BMD who underwent laparoscopic cholecystectomy for symptomatic cholelithiasis under total intravenous anesthesia without the use of muscle-relaxant drugs and supplemented with regional anesthesia. Anesthesia was induced and maintained with propofol, remifentanil, and fentanyl; ultrasound-guided bilateral rectus sheath block (RSB) and right-sided subcostal transversus abdominis plane block (TAP) were performed. The procedure required conversion to open surgery because of hard conglutination; intraoperative and postoperative periods were uneventful. Adequate analgesia was maintained after extubation because of the effect of RSB and TAP.

  6. Role of radiation therapy in patients with resectable pancreatic cancer.

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    Palta, Manisha; Willett, Christopher; Czito, Brian

    2011-07-01

    The 5-year overall survival of patients with pancreatic cancer is approximately 5%, with potentially resectable disease representing the curable minority. Although surgical resection remains the cornerstone of treatment, local and distant failure rates are high after complete resection, and debate continues as to the appropriate adjuvant therapy. Many oncologists advocate for adjuvant chemotherapy alone, given that high rates of systemic metastases are the primary cause of patient mortality. Others, however, view locoregional failure as a significant contributor to morbidity and mortality, thereby justifying the use of adjuvant chemoradiation. As in other gastrointestinal malignancies, neoadjuvant chemoradiotherapy offers potential advantages in resectable patients, and clinical investigation of this approach has shown promising results; however, phase III data are lacking. Further therapeutic advances and prospective trials are needed to better define the optimal role of adjuvant and neoadjuvant treatment in patients with resectable pancreatic cancer.

  7. Selection and Outcome of Portal Vein Resection in Pancreatic Cancer

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    Nakao, Akimasa

    2010-01-01

    Pancreatic cancer has the worst prognosis of all gastrointestinal neoplasms. Five-year survival of pancreatic cancer after pancreatectomy is very low, and surgical resection is the only option to cure this dismal disease. The standard surgical procedure is pancreatoduodenectomy (PD) for pancreatic head cancer. The morbidity and especially the mortality of PD have been greatly reduced. Portal vein resection in pancreatic cancer surgery is one attempt to increase resectability and radicality, and the procedure has become safe to perform. Clinicohistopathological studies have shown that the most important indication for portal vein resection in patients with pancreatic cancer is the ability to obtain cancer-free surgical margins. Otherwise, portal vein resection is contraindicated

  8. Selection and Outcome of Portal Vein Resection in Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nakao, Akimasa [Department of Surgery II, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 (Japan)

    2010-11-24

    Pancreatic cancer has the worst prognosis of all gastrointestinal neoplasms. Five-year survival of pancreatic cancer after pancreatectomy is very low, and surgical resection is the only option to cure this dismal disease. The standard surgical procedure is pancreatoduodenectomy (PD) for pancreatic head cancer. The morbidity and especially the mortality of PD have been greatly reduced. Portal vein resection in pancreatic cancer surgery is one attempt to increase resectability and radicality, and the procedure has become safe to perform. Clinicohistopathological studies have shown that the most important indication for portal vein resection in patients with pancreatic cancer is the ability to obtain cancer-free surgical margins. Otherwise, portal vein resection is contraindicated.

  9. Coblation-assisted endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma.

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    Ye, L; Zhou, X; Li, J; Jin, J

    2011-09-01

    Juvenile nasopharyngeal angiofibroma may be successfully resected using endoscopic techniques. However, the use of coblation technology for such resection has not been described. This study aimed to document cases of Fisch class I juvenile nasopharyngeal angiofibroma with limited nasopharyngeal and nasal cavity extension, which were completely resected using an endoscopic coblation technique. We retrospectively studied 23 patients with juvenile nasopharyngeal angiofibroma who underwent resection with either traditional endoscopic instruments (n = 12) or coblation (n = 11). Intra-operative blood loss and overall operative time were recorded. The mean tumour resection time for coblation and traditional endoscopic instruments was 87 and 136 minutes, respectively (t = 9.962, p angiofibroma (Fisch class I), with good surgical margins and minimal blood loss.

  10. The long-term results of resection and multiple resections in Crohn's disease.

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    Krupnick, A S; Morris, J B

    2000-01-01

    Crohn's disease is a panenteric, transmural inflammatory disease of unknown origin. Although primarily managed medically, 70% to 90% of patients will require surgical intervention. Surgery for small bowel Crohn's is usually necessary for unrelenting stenotic complications of the disease. Fistula, abscess, and perforation can also necessitate surgical intervention. Most patients benefit from resection or strictureplasty with an improved quality of life and remission of disease, but recurrence is common and 33% to 82% of patients will need a second operation, and 22% to 33% will require more than two resections. Short-bowel syndrome is unavoidable in a small percentage of Crohn's patients because of recurrent resection of affected small bowel and inflammatory destruction of the remaining mucosa. Although previously a lethal and unrelenting disease with death caused by malnutrition, patients with short-bowel syndrome today can lead productive lives with maintenance on total parenteral nutrition (TPN). This lifestyle, however, does not come without a price. Severe TPN-related complications, such as sepsis of indwelling central venous catheters and liver failure, do occur. Future developments will focus on more powerful and effective anti-inflammatory medication specifically targeting the immune mechanisms responsible for Crohn's disease. Successful medical management of the disease will alleviate the need for surgical resection and reduce the frequency of short-bowel syndrome. Improving the efficacy of immunosuppression and the understanding of tolerance induction should increase the safety and applicability of small-bowel transplant for those with short gut. Tissue engineering offers the potential to avoid immunosuppression altogether and supplement intestinal length using the patient's own tissues.

  11. Antagonistic Mono- and Bi-Articular Lower-Limb Muscle Activities’ Model Characterization at Different Speeds

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    Dzahir M.A.M

    2017-01-01

    Full Text Available Nowadays, medical rehabilitation system has become a requirement due to increment in national rehabilitation centres and medical hospitals. An assistive rehabilitation orthosis becomes essential and was used for rehabilitation therapy, condition monitoring, and physical strengthening. This study focused on the lower limb assistive rehabilitation orthosis development using pneumatic artificial muscle. To successfully control this orthosis system which consists of antagonistic mono- and biarticular muscle actuators, it is necessary to construct a reliable control algorithm. The suitable control scheme and strategy to manoeuvre this orthosis system similar to human musculoskeletal system have yet to be fully developed and established. Based on the review study, it is said that the co-contraction controls of anterior-posterior pneumatic muscles was able to improve the joint stiffness and stability of the orthosis as well as good manoeuvrability. Therefore, a characterization model of an antagonistic mono- and bi-articular muscles activities of human's lowerlimb during walking motion will be necessary. A healthy young male subject was used as test subject to obtain the sEMG muscle activities for antagonistic mono- and bi-articular muscles (i.e., Vastus Medialis-VM, Vastus Lateralis-VL, Rectus Femoris-RF, and Bicep Femoris-BF. The tests were carried out at different speeds of 2km/h, 3km/h, and 4km/h for one minute walking motion on a treadmill. Then, the patterns of the sEMG muscle activities were modelled and characterised using fifth order polynomial equation. Based on the results, it is shown that the anterior and posterior muscles were exhibited a muscle synergy in-between multiple anterior or posterior muscles and muscle co-contraction between anteriorposterior muscles in order to control the movements at the joints during walking motion. As conclusion, it is proven that the sEMG muscle activities of the antagonistic mono- and bi

  12. A model for morbidity after lung resection in octogenarians.

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    Berry, Mark F; Onaitis, Mark W; Tong, Betty C; Harpole, David H; D'Amico, Thomas A

    2011-06-01

    Age is an important risk factor for morbidity after lung resection. This study was performed to identify specific risk factors for complications after lung resection in octogenarians. A prospective database containing patients aged 80 years or older, who underwent lung resection at a single institution between January 2000 and June 2009, was reviewed. Preoperative, histopathologic, perioperative, and outcome variables were assessed. Morbidity was measured as a patient having any perioperative event as defined by the Society of Thoracic Surgeons General Thoracic Surgery Database. A multivariable risk model for morbidity was developed using a panel of established preoperative and operative variables. Survival was calculated using the Kaplan-Meier method. During the study period, 193 patients aged 80 years or older (median age 82 years) underwent lung resection: wedge resection in 77, segmentectomy in 13, lobectomy in 96, bilobectomy in four, and pneumonectomy in three. Resection was accomplished via thoracoscopy in 149 patients (77%). Operative mortality was 3.6% (seven patients) and morbidity was 46% (89 patients). A total of 181 (94%) patients were discharged directly home. Postoperative events included atrial arrhythmia in 38 patients (20%), prolonged air leak in 24 patients (12%), postoperative transfusion in 22 patients (11%), delirium in 16 patients (8%), need for bronchoscopy in 14 patients (7%), and pneumonia in 10 patients (5%). Significant predictors of morbidity by multivariable analysis included resection greater than wedge (odds ratio 2.98, p=0.006), thoracotomy as operative approach (odds ratio 2.6, p=0.03), and % predicted forced expiratory volume in 1s (odds ratio 1.28 for each 10% decrement, p=0.01). Octogenarians can undergo lung resection with low mortality. Extent of resection, use of a thoracotomy, and impaired lung function increase the risk of complications. Careful evaluation is necessary to select the most appropriate approach in

  13. Extrahepatic bile duct resection in combination with liver resection for hilar cholangiocarcinoma : A report of 42 cases

    NARCIS (Netherlands)

    IJitsma, AJC; Appeltans, BMG; de Jong, KP; Porte, RJ; Peeters, PMJG; Slooff, MJH

    2004-01-01

    From September 1986 until December 2001, 42 patients (20 males and 22 females) underwent a combined extrahepatic bile duct resection (EHBDR) and liver resection (LR) for hilar cholangiocarcinoma (HC). The aim of this study was to analyze patient survival, morbidity, and mortality as well as to seek

  14. Effects of non-paretic arm exercises using a tubing band on abdominal muscle activity in stroke patients.

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    Lee, Dong-Kyu; Kang, Min-Hyeok; Kim, Ji-Won; Kim, Yang-Gon; Park, Ji-Hyuk; Oh, Jae-Seop

    2013-01-01

    Abdominal strengthening exercises are important for stroke patients; however, there is a lack of research on therapeutic exercises for increasing abdominal muscle activity in stroke patients. We investigated the effects of non-paretic arm exercises using a tubing band on abdominal muscle activity in stroke patients. In total, 18 hemiplegic subjects (13 males, 5 females) were recruited. All subjects performed non-paretic arm exercises involving three different shoulder movements (extension, flexion, and horizontal abduction) using an elastic tubing band. Surface electromyography (EMG) signals were recorded from the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles bilaterally during non-paretic arm exercises. EMG activities of abdominal muscles during non-paretic arm extension and horizontal abduction were increased significantly versus shoulder flexion when subjects performed the arm exercise in a seated position. Muscle activity of the EO was significantly greater in the paretic than the non-paretic side during non-paretic arm extension and horizontal abduction. We suggest that non-paretic arm extension and horizontal abduction exercises using an elastic tubing band may be effective in increasing abdominal muscle activity.

  15. Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study

    Directory of Open Access Journals (Sweden)

    Ptaszkowski K

    2015-09-01

    Full Text Available Kuba Ptaszkowski,1 Małgorzata Paprocka-Borowicz,2 Lucyna Słupska,2 Janusz Bartnicki,1,3 Robert Dymarek,4 Joanna Rosińczuk,4 Jerzy Heimrath,5 Janusz Dembowski,6 Romuald Zdrojowy6 1Department of Obstetrics, 2Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Wroclaw Medical University, Wroclaw, Poland; 3Department of Obstetrics and Gynecology, Health Center Bitterfeld/Wolfen gGmbH, Bitterfeld-Wolfen, Germany; 4Department of Nervous System Diseases, 5Department of Gynaecology and Obstetrics, Faculty of Health Science, 6Department and Clinic of Urology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Poland Objective: Muscles such as adductor magnus (AM, gluteus maximus (GM, rectus abdominis (RA, and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI, and the relationship between contraction of these muscles and pelvic floor muscles (PFM has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM during resting and functional PFM activation in postmenopausal women with and without SUI.Materials and methods: This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16 and continent women (n=14. The bioelectrical activity of PFM and SPFM (AM, RA, GM was

  16. BUILDING A BETTER GLUTEAL BRIDGE: ELECTROMYOGRAPHIC ANALYSIS OF HIP MUSCLE ACTIVITY DURING MODIFIED SINGLE-LEG BRIDGES.

    Science.gov (United States)

    Lehecka, B J; Edwards, Michael; Haverkamp, Ryan; Martin, Lani; Porter, Kambry; Thach, Kailey; Sack, Richard J; Hakansson, Nils A

    2017-08-01

    Gluteal strength plays a role in injury prevention, normal gait patterns, eliminating pain, and enhancing athletic performance. Research shows high gluteal muscle activity during a single-leg bridge compared to other gluteal strengthening exercises; however, prior studies have primarily measured muscle activity with the active lower extremity starting in 90 ° of knee flexion with an extended contralateral knee. This standard position has caused reports of hamstring cramping, which may impede optimal gluteal strengthening. The purpose of this study was to determine which modified position for the single-leg bridge is best for preferentially activating the gluteus maximus and medius. Cross-Sectional. Twenty-eight healthy males and females aged 18-30 years were tested in five different, randomized single-leg bridge positions. Electromyography (EMG) electrodes were placed on subjects' gluteus maximus, gluteus medius, rectus femoris, and biceps femoris of their bridge leg (i.e., dominant or kicking leg), as well as the rectus femoris of their contralateral leg. Subjects performed a maximal voluntary isometric contraction (MVIC) for each tested muscle prior to performing five different bridge positions in randomized order. All bridge EMG data were normalized to the corresponding muscle MVIC data. A modified bridge position with the knee of the bridge leg flexed to 135 ° versus the traditional 90 ° of knee flexion demonstrated preferential activation of the gluteus maximus and gluteus medius compared to the traditional single-leg bridge. Hamstring activation significantly decreased (p bridge by flexing the active knee to 135 ° instead of 90 ° minimizes hamstring activity while maintaining high levels of gluteal activation, effectively building a bridge better suited for preferential gluteal activation. 3.

  17. Repeated stimulation, inter-stimulus interval and inter-electrode distance alters muscle contractile properties as measured by Tensiomyography.

    Directory of Open Access Journals (Sweden)

    Hannah V Wilson

    Full Text Available The influence of methodological parameters on the measurement of muscle contractile properties using Tensiomyography (TMG has not been published.To investigate the; (1 reliability of stimulus amplitude needed to elicit maximum muscle displacement (Dm, (2 effect of changing inter-stimulus interval on Dm (using a fixed stimulus amplitude and contraction time (Tc, (3 the effect of changing inter-electrode distance on Dm and Tc.Within subject, repeated measures.10 participants for each objective.Dm and Tc of the rectus femoris, measured using TMG.The coefficient of variance (CV and the intra-class correlation (ICC of stimulus amplitude needed to elicit maximum Dm was 5.7% and 0.92 respectively. Dm was higher when using an inter-electrode distance of 7cm compared to 5cm [P = 0.03] and when using an inter-stimulus interval of 10s compared to 30s [P = 0.017]. Further analysis of inter-stimulus interval data, found that during 10 repeated stimuli Tc became faster after the 5th measure when compared to the second measure [P<0.05]. The 30s inter-stimulus interval produced the most stable Tc over 10 measures compared to 10s and 5s respectively.Our data suggest that the stimulus amplitude producing maximum Dm of the rectus femoris is reliable. Inter-electrode distance and inter-stimulus interval can significantly influence Dm and/ or Tc. Our results support the use of a 30s inter-stimulus interval over 10s or 5s. Future studies should determine the influence of methodological parameters on muscle contractile properties in a range of muscles.

  18. Repeated stimulation, inter-stimulus interval and inter-electrode distance alters muscle contractile properties as measured by Tensiomyography

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    Johnson, Mark I.; Francis, Peter

    2018-01-01

    Context The influence of methodological parameters on the measurement of muscle contractile properties using Tensiomyography (TMG) has not been published. Objective To investigate the; (1) reliability of stimulus amplitude needed to elicit maximum muscle displacement (Dm), (2) effect of changing inter-stimulus interval on Dm (using a fixed stimulus amplitude) and contraction time (Tc), (3) the effect of changing inter-electrode distance on Dm and Tc. Design Within s